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Sample records for integrative medical approach

  1. Child Psychotherapy, Child Analysis, and Medication: A Flexible, Integrative Approach.

    Science.gov (United States)

    Whitman, Laura

    2015-01-01

    For children with moderate to severe emotional or behavioral problems, the current approach in child psychiatry is to make an assessment for the use of both psychotherapy and medication. This paper describes integration of antidepressants and stimulants with psychoanalytically oriented techniques.

  2. A mobile agent approach for secure integrated medical information systems.

    Science.gov (United States)

    Liu, Chia-Hui; Chung, Yu-Fang; Chiang, Te-Wei; Chen, Tzer-Shyong; Wang, Sheng-De

    2012-10-01

    Different patient-related information in medical organizations is the primary reference for medical personnel diagnosing, treating, and caring patients. With the rapid development of information technology, paper-based medical records have gradually been changed to electronic forms. However, different medical organizations present individual system specifications and data-saving formats so that the medical information of the same patient cannot be exchanged, shared, and securely accessed. In order not to largely change the present medical information systems as well as not to increase abundant costs, Virtual Integrated Medical-information Systems (VIMS) is proposed to assist various hospitals in information exchange. Furthermore, with Mobile Agent, the dispersed medical information can be securely integrated. It presents confidentiality, non-repudiation, source authentication, and integrity in network transmission. Virtual Integrated Medical-information Systems (VIMS) is a virtual electronic integration system combined with Mobile Agent technology. With the features of independence, adaptability, mobility, objectives, and autonomy, Mobile Agent is applied to overcome the problems from heterogeneous systems. With the features, the over-dispersed medical records can be integrated. Moreover, Mobile Agent can ensure the instantaneity and usability of medical records from which doctors can make the most appropriate evaluation and diagnoses. It will avoid the waste of medical resources, such as repetition medication, as well as become the reference of further consultation or health check. Not only can it improve the medical care quality, but it can be provided for medical research.

  3. Tackling burden in ART: an integrated approach for medical staff.

    Science.gov (United States)

    Boivin, Jacky; Domar, Alice D; Shapiro, Daniel B; Wischmann, Tewes H; Fauser, Bart C J M; Verhaak, Christianne

    2012-04-01

    Discontinuation is a problem in fertility clinics. Many couples discontinue assisted reproductive technologies (ART) without achieving a live birth for reasons other than poor prognosis or the cost of treatment. Discontinuation has been attributed to the burden of treatment. The causes of burden can be broadly classified according to whether they originate in the patient, clinic or treatment. Interventions to alleviate these burdens include provision of comprehensive educational material, screening to identify highly distressed patients, provision of tailored coping tools and improvements in the clinic environment and medical interventions. Practical interventions to reduce the different causes of burden in ART exist, but further development and evaluation of the efficacy of these interventions requires more precise definition of terms and theory. In this paper, we propose a general integrated approach to cover different perspectives in dealing with burden in ART clinics. We firstly describe the integrated approach and present common sources of burden. We then describe interventions that could help reduce the burden in ART. Our paper is aimed at fertility clinic staff because of their day-to-day involvement with patients. However, this discussion should also be relevant to companies that develop treatments and to psychosocial experts. Reducing the burden of treatment should lead to improved outcomes, namely better quality of life during treatment and lower discontinuation rates.

  4. Integrating radiology vertically into an undergraduate medical education curriculum: a triphasic integration approach

    Directory of Open Access Journals (Sweden)

    Al Qahtani F

    2014-06-01

    Full Text Available Fahd Al Qahtani,1 Adel Abdelaziz2,31Radiology Department, Faculty of Medicine, Al-Baha University, Al-Baha, Saudi Arabia; 2Medical Education Development Unit, Faculty of Medicine, Al-Baha University, Al-Baha, Saudi Arabia; 3Medical Education Department, Faculty of Medicine, Suez Canal University, Ismailia, EgyptAbstract: Fulfilling the goal of integrating radiology into undergraduate medical curricula is a real challenge due to the enduring faith assuming that traditional medical disciplines are worthy of consuming the available study time. In this manner, radiology is addressed occasionally and with relevance to these traditional disciplines. In Al-Baha University Faculty of Medicine, Al-Baha, Saudi Arabia, efforts have been made to integrate radiology vertically and in a structured manner into the undergraduate curriculum from the first year to the sixth year. For achieving convenient integration of radiology, a triphasic approach to integration is adopted. This approach consists of the integration of radiology foundations into the basic sciences phase, development of a distinct 4-week module in year 4, and finally, integration of clinical applications of radiology in the clinical phase modules. Feedback of students and inferences obtained through assessment and program evaluation are in favor of this approach to integration. Minor reform and some improvement related to time allocated and content balancing are still indicated.Keywords: radiology foundations, radiology module, students assessment

  5. Posterior Approach to Kidney Dissection: An Old Surgical Approach for Integrated Medical Curricula

    Science.gov (United States)

    Daly, Frank J.; Bolender, David L.; Jain, Deepali; Uyeda, Sheryl; Hoagland, Todd M.

    2015-01-01

    Integrated medical curricular changes are altering the historical regional anatomy approach to abdominal dissection. The renal system is linked physiologically and biochemically to the cardiovascular and respiratory systems; yet, anatomists often approach the urinary system as part of the abdomen and pelvic regions. As part of an integrated…

  6. Posterior Approach to Kidney Dissection: An Old Surgical Approach for Integrated Medical Curricula

    Science.gov (United States)

    Daly, Frank J.; Bolender, David L.; Jain, Deepali; Uyeda, Sheryl; Hoagland, Todd M.

    2015-01-01

    Integrated medical curricular changes are altering the historical regional anatomy approach to abdominal dissection. The renal system is linked physiologically and biochemically to the cardiovascular and respiratory systems; yet, anatomists often approach the urinary system as part of the abdomen and pelvic regions. As part of an integrated…

  7. Integrating medical and research information: a big data approach.

    Science.gov (United States)

    Tilve Álvarez, Carlos M; Ayora Pais, Alberto; Ruíz Romero, Cristina; Llamas Gómez, Daniel; Carrajo García, Lino; Blanco García, Francisco J; Vázquez González, Guillermo

    2015-01-01

    Most of the information collected in different fields by Instituto de Investigación Biomédica de A Coruña (INIBIC) is classified as unstructured due to its high volume and heterogeneity. This situation, linked to the recent requirement of integrating it to the medical information, makes it necessary to implant specific architectures to collect and organize it before it can be analysed. The purpose of this article is to present the Hadoop framework as a solution to the problem of integrating research information in the Business Intelligence field. This framework can collect, explore, process and structure the aforementioned information, which allow us to develop an equivalent function to a data mart in an Intelligence Business system.

  8. Communication Skills in Medical Education: An Integrated Approach

    Science.gov (United States)

    Bennett, Kellie; Lyons, Zaza

    2011-01-01

    The importance of teaching communication skills in any undergraduate medical curriculum cannot be overstated. Effective doctor-patient communication is widely recognised as an essential aspect of quality patient care. A communication skills module developed for first year medical students at the University of Western Australia (UWA) is described…

  9. Communication Skills in Medical Education: An Integrated Approach

    Science.gov (United States)

    Bennett, Kellie; Lyons, Zaza

    2011-01-01

    The importance of teaching communication skills in any undergraduate medical curriculum cannot be overstated. Effective doctor-patient communication is widely recognised as an essential aspect of quality patient care. A communication skills module developed for first year medical students at the University of Western Australia (UWA) is described…

  10. A community-based approach for integrating geriatrics and gerontology into undergraduate medical education.

    Science.gov (United States)

    Martinez, Iveris L; Mora, Jorge Camilo

    2012-01-01

    Medical school accreditation requirements require educational opportunities in geriatrics. Twenty-six minimum graduating competencies in geriatrics have recently been identified for medical students. The authors describe how these competencies are being integrated into a new medical curriculum through coursework and community-based experiences. This approach is intended to expose students to older adults from diverse communities and adequately prepare students to address the complex and individual needs of these patients. Initial results indicate proficiency in the minimum geriatric competencies covered. The growth and diversity of the older adult population makes it important to integrate and evaluate geriatrics education in undergraduate medical education.

  11. Evidence-based medicine (EBM) for undergraduate medical students: A six-step, integrative approach.

    Science.gov (United States)

    Atwa, Hani; Abdelaziz, Adel

    2017-04-01

    Nowadays, there is an increasing interest in practicing evidence-based medicine (EBM) to provide valid and up-to-date information about health problems and procedures for solving these problems. However, studying EBM among other medical education disciplines remains unsatisfactory. To design and pilot a basic course on EBM for undergraduate medical students in order to raise the awareness of the Saudi medical education community about this discipline. The developed course targeted undergraduate Year 4 medical students at Ibn Sina National College for Medical Studies in Jeddah, Saudi Arabia. The course was integrated longitudinally into ?Integrated Multisystem Module? of Year 4. Students and faculty perceptions were evaluated for program evaluation purposes. Course design was based on Kern et al. six-step approach for curriculum development. Students overall perception of this course was positive except for some points related to the time allocated and their training on using evidence databases. Faculty members who participated in implementing the course perceived it positively. Teaching EBM is recommended and applicable. It is not resource-intensive, and can be conducted through developing and integrating EBM courses in the undergraduate medical curriculum. Students and teachers agree upon the need and importance of teaching such discipline.

  12. 78 FR 10181 - Global Quality Systems-An Integrated Approach To Improving Medical Product Safety; Public Workshop

    Science.gov (United States)

    2013-02-13

    ... ``Global Quality Systems--An Integrated Approach to Improving Medical Product Safety.'' This 2-day public... HUMAN SERVICES Food and Drug Administration Global Quality Systems--An Integrated Approach To Improving Medical Product Safety; Public Workshop AGENCY: Food and Drug Administration, HHS. ACTION: Notice of...

  13. Utilizing Electronic Health Record Information to Optimize Medication Infusion Devices: A Manual Data Integration Approach.

    Science.gov (United States)

    Chuk, Amanda; Maloney, Robert; Gawron, Joyce; Skinner, Colin

    Health information technology is increasingly utilized within healthcare delivery systems today. Two examples of this type of technology include the capture of patient-specific information within an electronic health record and intravenous medication infusion devices equipped with dose error reduction software known as drug libraries. Automatic integration of these systems, termed intravenous (IV) interoperability, should serve as the goal toward which all healthcare systems work to maximize patient safety. For institutions lacking IV interoperability, we describe a manual approach of querying the electronic health record to incorporate medication administration information with data from infusion device software to optimize drug library settings. This approach serves to maximize utilization of available information to optimize medication safety provided by drug library software.

  14. Integrated approach in the development of competencies valeological students - medical doctor

    Directory of Open Access Journals (Sweden)

    Ostafijchuk Y.F.

    2013-11-01

    Full Text Available The analysis of the scientific - methodical sources. We prove the feasibility of using an integrative approach in the training of future health professionals. Scientists are perspectives on the essence of the concept of integration, their position relative to integrative learning in higher education. Integrative learning is seen as a new educational technology. The basic components of the integration of modern science: Interscience synthesis, synthesis of methodological, social synthesis. It is found that an integrative technology is based on the principles of integrative and personal - oriented education. Reveals the main ways of implementing these principles: the design of interdisciplinary integration, the identification of the same type of interdisciplinary topics; orientation training content on the personality of the student, the formation integrity valeological knowledge and practical skills (in the context valeological behavior. Lit their own opinions of the authors on the formation valeological competence of students of medical colleges in the integration environment. Predicted the final result of this process - a methodological willingness of future health professionals to use valeological component in professional activities.

  15. A Community-Based Approach for Integrating Geriatrics and Gerontology into Undergraduate Medical Education

    Science.gov (United States)

    Martinez, Iveris L.; Mora, Jorge Camilo

    2012-01-01

    Medical school accreditation requirements require educational opportunities in geriatrics. Twenty-six minimum graduating competencies in geriatrics have recently been identified for medical students. The authors describe how these competencies are being integrated into a new medical curriculum through coursework and community-based experiences.…

  16. A Community-Based Approach for Integrating Geriatrics and Gerontology into Undergraduate Medical Education

    Science.gov (United States)

    Martinez, Iveris L.; Mora, Jorge Camilo

    2012-01-01

    Medical school accreditation requirements require educational opportunities in geriatrics. Twenty-six minimum graduating competencies in geriatrics have recently been identified for medical students. The authors describe how these competencies are being integrated into a new medical curriculum through coursework and community-based experiences.…

  17. An integrated approach to distance learning with digital video in the French-speaking Virtual Medical University.

    Science.gov (United States)

    Dufour, J C; Cuggia, M; Soula, G; Spector, M; Kohler, F

    2007-01-01

    The aim of the French-speaking Virtual Medical University project (UMVF) is to share common resources and specific tools in order to improve medical training. Digital video on IP is an attractive tool for higher education but there are a number of obstacles to widespread implementation. This paper describes the UMVF approach to integrating digital video technologies and services in educational projects.

  18. Vertical Integration in Teaching And Learning (VITAL): an approach to medical education in general practice.

    Science.gov (United States)

    Dick, Marie-Louise B; King, David B; Mitchell, Geoffrey K; Kelly, Glynn D; Buckley, John F; Garside, Susan J

    2007-07-16

    There is increasing demand to provide clinical and teaching experiences in the general practice setting. Vertical integration in teaching and learning, whereby teaching and learning roles are shared across all learner stages, has the potential to decrease time demands and stress on general practitioners, to provide teaching skills and experience to GP registrars, and to improve the learning experience for medical students, and may also help meet the increased demand for teaching in general practice. We consider potential advantages and barriers to vertical integration of teaching in general practice, and provide results of focus group discussions with general practice principals and registrars about vertical integration. We recommend further research into the feasibility of using vertical integration to enhance the capacity to teach medical students in general practice.

  19. Integrating health economics modeling in the product development cycle of medical devices: a Bayesian approach.

    Science.gov (United States)

    Vallejo-Torres, Laura; Steuten, Lotte M G; Buxton, Martin J; Girling, Alan J; Lilford, Richard J; Young, Terry

    2008-01-01

    Medical device companies are under growing pressure to provide health-economic evaluations of their products. Cost-effectiveness analyses are commonly undertaken as a one-off exercise at the late stage of development of new technologies; however, the benefits of an iterative use of economic evaluation during the development process of new products have been acknowledged in the literature. Furthermore, the use of Bayesian methods within health technology assessment has been shown to be of particular value in the dynamic framework of technology appraisal when new information becomes available in the life cycle of technologies. In this study, we set out a methodology to adapt these methods for their application to directly support investment decisions in a commercial setting from early stages of the development of new medical devices. Starting with relatively simple analysis from the very early development phase and proceeding to greater depth of analysis at later stages, a Bayesian approach facilitates the incorporation of all available evidence and would help companies to make better informed choices at each decision point.

  20. Improving the Efficiency of Medical Services Systems: A New Integrated Mathematical Modeling Approach

    Directory of Open Access Journals (Sweden)

    Davood Shishebori

    2013-01-01

    Full Text Available Nowadays, the efficient design of medical service systems plays a critical role in improving the performance and efficiency of medical services provided by governments. Accordingly, health care planners in countries especially with a system based on a National Health Service (NHS try to make decisions on where to locate and how to organize medical services regarding several conditions in different residence areas, so as to improve the geographic equity of comfortable access in the delivery of medical services while accounting for efficiency and cost issues especially in crucial situations. Therefore, optimally locating of such services and also suitable allocating demands them, can help to enhance the performance and responsiveness of medical services system. In this paper, a multiobjective mixed integer nonlinear programming model is proposed to decide locations of new medical system centers, link roads that should be constructed or improved, and also urban residence centers covered by these medical service centers and link roads under investment budget constraint in order to both minimize the total transportation cost of the overall system and minimize the total failure cost (i.e., maximize the system reliability of medical service centers under unforeseen situations. Then, the proposed model is linearized by suitable techniques. Moreover, a practical case study is presented in detail to illustrate the application of the proposed mathematical model. Finally, a sensitivity analysis is done to provide an insight into the behavior of the proposed model in response to changes of key parameters of the problem.

  1. Integrating and Evaluating Geriatrics in Medical School: A Novel Approach for the Challenge

    Science.gov (United States)

    Besdine, Richard W.; Shield, Renee R.; McNicoll, Lynn; Campbell, Susan E.; Wetle, Terrie

    2011-01-01

    Brown Medical School developed a comprehensive curriculum in which enriched aging content increased from 22 to 80 hours in preclerkship courses and was also added for clerkships, residencies, and nongeriatrician physicians. Innovative evaluation strategies are also described. Highlights include "treasure hunts" in the anatomy laboratory, a…

  2. Integrating and Evaluating Geriatrics in Medical School: A Novel Approach for the Challenge

    Science.gov (United States)

    Besdine, Richard W.; Shield, Renee R.; McNicoll, Lynn; Campbell, Susan E.; Wetle, Terrie

    2011-01-01

    Brown Medical School developed a comprehensive curriculum in which enriched aging content increased from 22 to 80 hours in preclerkship courses and was also added for clerkships, residencies, and nongeriatrician physicians. Innovative evaluation strategies are also described. Highlights include "treasure hunts" in the anatomy laboratory, a…

  3. Integrating health economics modeling in the product development cycle of medical devices: A Bayesian approach

    NARCIS (Netherlands)

    Vallejo-Torres, Laura; Steuten, Lotte Maria Gertruda; Buxton, Martin J.; Girling, Alan J.; Lilford, Richard J.; Young, Terry

    2008-01-01

    Objectives: Medical device companies are under growing pressure to provide health-economic evaluations of their products. Cost-effectiveness analyses are commonly undertaken as a one-off exercise at the late stage of development of new technologies; however, the benefits of an iterative use of

  4. Integrative Approach to Quality Assessment of Medical Journals Using Impact Factor, Eigenfactor, and Article Influence Scores

    Science.gov (United States)

    Rizkallah, Jacques; Sin, Don D.

    2010-01-01

    Background Impact factor (IF) is a commonly used surrogate for assessing the scientific quality of journals and articles. There is growing discontent in the medical community with the use of this quality assessment tool because of its many inherent limitations. To help address such concerns, Eigenfactor (ES) and Article Influence scores (AIS) have been devised to assess scientific impact of journals. The principal aim was to compare the temporal trends in IF, ES, and AIS on the rank order of leading medical journals over time. Methods The 2001 to 2008 IF, ES, AIS, and number of citable items (CI) of 35 leading medical journals were collected from the Institute of Scientific Information (ISI) and the http://www.eigenfactor.org databases. The journals were ranked based on the published 2008 ES, AIS, and IF scores. Temporal score trends and variations were analyzed. Results In general, the AIS and IF values provided similar rank orders. Using ES values resulted in large changes in the rank orders with higher ranking being assigned to journals that publish a large volume of articles. Since 2001, the IF and AIS of most journals increased significantly; however the ES increased in only 51% of the journals in the analysis. Conversely, 26% of journals experienced a downward trend in their ES, while the rest experienced no significant changes (23%). This discordance between temporal trends in IF and ES was largely driven by temporal changes in the number of CI published by the journals. Conclusion The rank order of medical journals changes depending on whether IF, AIS or ES is used. All of these metrics are sensitive to the number of citable items published by journals. Consumers should thus consider all of these metrics rather than just IF alone in assessing the influence and importance of medical journals in their respective disciplines. PMID:20419115

  5. Case method teaching: an effective approach to integrate the basic and clinical sciences in the preclinical medical curriculum.

    Science.gov (United States)

    Bowe, Constance M; Voss, John; Thomas Aretz, H

    2009-09-01

    Recent efforts to identify the essential skills and competencies required for medical practice have resulted in an expansion of the educational outcomes for which medical schools are accountable. Teachers in the preclinical years, formerly focused on the transmission of biomedical principles and factual information, are now charged with presenting discipline-specific concepts with an emphasis on clinical relevance while advancing active learning, critical thinking, communication skills, and other professional competencies. Problem-based learning has been widely introduced to support these educational goals but other, less resource-intensive, discussion methodologies have not been extensively explored. To examine the feasibility of case-method teaching (CMT) during the preclinical curricula to integrate basic science concepts in the management of clinical problems. CMT sessions were conducted with students during the first- and second-year of hybrid curricula at two US medical schools. First- and second-year medical classes of 40-95 students prepared for and actively engaged in single session case discussions and were able to productively apply basic science principles in clinical problem-solving. CMT represents a feasible and resource-conservative pedagogical format to promote critical thinking and to integrate basic science principles during the preclinical curriculum.

  6. A Case Based-Shared Teaching Approach in Undergraduate Medical Curriculum: A Way for Integration in Basic and Clinical Sciences

    National Research Council Canada - National Science Library

    Soheil Peiman; Azim Mirzazadeh; Maryam Alizadeh; Sara Mortaz Hejri; Mohammad-Taghi Najafi; Abbas Tafakhori; Farnoosh Larti; Besharat Rahimi; Babak Geraiely; Parichehr Pasbakhsh; Gholamreza Hassanzadeh; Fatemeh Nabavizadeh Rafsanjani; Mohammad Ansari; Seyed Farshad Allameh

    2017-01-01

    ...; Problem based learning; Medical students Introduction There is a growing interest in the connection between basic and clinical sciences in teaching, and learning strategies and the medical schools seek to train medical...

  7. Integration a functional approach

    CERN Document Server

    Bichteler, Klaus

    1998-01-01

    This book covers Lebesgue integration and its generalizations from Daniell's point of view, modified by the use of seminorms. Integrating functions rather than measuring sets is posited as the main purpose of measure theory. From this point of view Lebesgue's integral can be had as a rather straightforward, even simplistic, extension of Riemann's integral; and its aims, definitions, and procedures can be motivated at an elementary level. The notion of measurability, for example, is suggested by Littlewood's observations rather than being conveyed authoritatively through definitions of (sigma)-algebras and good-cut-conditions, the latter of which are hard to justify and thus appear mysterious, even nettlesome, to the beginner. The approach taken provides the additional benefit of cutting the labor in half. The use of seminorms, ubiquitous in modern analysis, speeds things up even further. The book is intended for the reader who has some experience with proofs, a beginning graduate student for example. It might...

  8. Integrating Public Health and Health Promotion Practice in the Medical Curriculum: A Self-Directed Team-Based Project Approach.

    Science.gov (United States)

    Kershaw, Geraldine; Grivna, Michal; Elbarazi, Iffat; AliHassan, Souheila; Aziz, Faisal; Al Dhaheri, Aysha Ibrahim

    2017-01-01

    Preparing health professionals in health promotion (HP) and disease prevention is essential for improvement of population health, community HP, and better health care for individuals. The aim of this article is to describe an HP project in the form of a major self-directed project-based learning task integrated within the curriculum in the second year of the medical degree program at United Arab Emirates University. The project introduces students to public health and HP practice and develops students' literature searching, writing, presentation skills, and team work. Students learn the principles underlying behavioral change, and the design of HP programs and materials, through a lecture format. Small groups of students each choose a specific health topic for their project. Over 11 weeks, students obtain information about their topic from appropriate sources (library, PubMed, Google Scholar, credible health sources such as World Health Organization). Using the principles learned in the lectures, they develop appropriate materials for their target audience: for example, posters, a pamphlet, social media content, or a video or radio message. Students seek advice from specialist faculty as needed. In week 12, each team presents their project background, rationale, and materials to their colleagues in a seminar format open to all faculty. They then submit the materials they developed for assessment. Group marks are assigned for presentations and materials. Key concepts are assessed by multiple choice questions in comprehensive course examinations. By participation in the HP project, many students develop a solid background in prevention. The information retrieval, writing, and presentation skills, as well as experience of team work, are valuable both for the remaining years of their training and their future careers.

  9. Thinking about thinking and emotion: the metacognitive approach to the medical humanities that integrates the humanities with the basic and clinical sciences.

    Science.gov (United States)

    Eichbaum, Quentin G

    2014-01-01

    Medical knowledge in recent decades has grown prodigiously and has outstripped the capacity of the human brain to absorb and understand it all. This burgeoning of knowledge has created a dilemma for medical educators. We can no longer expect students to continue memorizing this large body of increasingly complex knowledge. Instead, our efforts should be redirected at developing in students a competency as flexible thinkers and agile learners so they can adeptly deal with new knowledge, complexity, and uncertainty in a rapidly changing world. Such a competency would entail not only cognitive but also emotional skills essential for the holistic development of their professional identity. This article will argue that metacognition--“thinking about thinking (and emotion)”--offers the most viable path toward developing this competency. The overwhelming volume of medical knowledge has driven some medical schools to reduce the time allocated in their curricula to the “soft-option” humanities as they tend to consider them an expendable “luxury.” Vanderbilt University School of Medicine, Nashville, TN, has moved away from the traditional conception of the medical humanities as “the arts,” composed of art, music, and literature, toward an approach that integrates the humanities with the basic and clinical sciences, based on metacognition. This metacognitive approach to the humanities, described in this article, has three goals: 1) to develop students as flexible thinkers and agile learners and to provide them with essential cognitive and emotional skills for navigating medical complexity and uncertainty; 2) to elicit in students empathy and tolerance by making them aware of the immense diversity in human cognition (and emotion); and 3) to integrate the humanities with the basic and clinical sciences. Through this metacognitive approach, students come to understand their patterns of cognition and emotions, and in the group setting, they learn to mindfully

  10. APPROACHES TO PUBLIC INTEGRITY

    Directory of Open Access Journals (Sweden)

    Simona-Roxana ULMAN

    2015-08-01

    Full Text Available Both concepts, integrity and public integrity, are always asked qualities in the social and economic environment, but they are never well defined. In this context, finding precise definitions and offering an ample explanation of the concepts are desired and useful for both economic theoretical and practical levels and become the aim of the present paper. Without a good understanding of a concept, no one is capable to attain it. In this context, it is impossible to ask for a public sector of integrity if both public actors and the citizens do not know what it really means. Therefore, the public actors first have to understand what integrity really supposes, and, then, to be capable to respect its principles. Taking into consideration the effects of public integrity or, on its opposite, of the divergence from it, especially represented by the phenomenon of corruption, on the economy at the macro, but also, on the micro level, public integrity in itself becomes a real economic problem that is aimed to be extensively analyzed through our interdisciplinary approach.

  11. Integrative health coaching: a behavior skills approach that improves HbA1c and pharmacy claims-derived medication adherence.

    Science.gov (United States)

    Wolever, Ruth Q; Dreusicke, Mark H

    2016-01-01

    Medication adherence requires underlying behavior skills and a supporting mindset that may not be addressed with education or reminders. Founded in the study of internal motivation and health psychology, integrative health coaching (IHC) helps patients gain insight into their behaviors and make long-term, sustainable lifestyle changes. The purpose of the study is to determine whether IHC improves oral medication adherence, glycated hemoglobin (HbA1c), and psychosocial measures, and to assess whether adherence changes are sustained after the intervention. Using a prospective observational design, participants (n=56) received 14 coaching calls by telephone over 6 months. Medication possession ratio (MPR) was calculated for time intervals before, during, and after the intervention. HbA1c and patient-reported psychosocial outcomes were obtained to test interactions with MPR. Medication adherence (MPR) increased from 0.74±0.197 to 0.85±0.155 during coaching, and was sustained at 0.82±0.175 during a 6-month period after the study. Better adherence correlated with a greater decrease in HbA1c. HbA1c decreased from 8.0±1.92% to 7.7±1.70% over the 6-month intervention. All psychosocial measures showed significant improvement. In addition to discussing medication adherence strategies with their coach, patients discussed nutrition and exercise (86.9% of calls), stress management (39.8%), and social support and relationships (15.4%). IHC targets internal motivation and supports behavior change by facilitating patients' insight into their own behaviors, and it uses this insight to foster self-efficacy. This approach may yield sustainable results for medication adherence and warrants further exploration for health-related behavior change.

  12. Medical Image Retrieval: A Multimodal Approach.

    Science.gov (United States)

    Cao, Yu; Steffey, Shawn; He, Jianbiao; Xiao, Degui; Tao, Cui; Chen, Ping; Müller, Henning

    2014-01-01

    Medical imaging is becoming a vital component of war on cancer. Tremendous amounts of medical image data are captured and recorded in a digital format during cancer care and cancer research. Facing such an unprecedented volume of image data with heterogeneous image modalities, it is necessary to develop effective and efficient content-based medical image retrieval systems for cancer clinical practice and research. While substantial progress has been made in different areas of content-based image retrieval (CBIR) research, direct applications of existing CBIR techniques to the medical images produced unsatisfactory results, because of the unique characteristics of medical images. In this paper, we develop a new multimodal medical image retrieval approach based on the recent advances in the statistical graphic model and deep learning. Specifically, we first investigate a new extended probabilistic Latent Semantic Analysis model to integrate the visual and textual information from medical images to bridge the semantic gap. We then develop a new deep Boltzmann machine-based multimodal learning model to learn the joint density model from multimodal information in order to derive the missing modality. Experimental results with large volume of real-world medical images have shown that our new approach is a promising solution for the next-generation medical imaging indexing and retrieval system.

  13. Systems innovation model: an integrated interdisciplinary team approach pre- and post-bariatric surgery at a veterans affairs (VA) medical center.

    Science.gov (United States)

    Eisenberg, Dan; Lohnberg, Jessica A; Kubat, Eric P; Bates, Cheryl C; Greenberg, Lauren M; Frayne, Susan M

    2017-04-01

    Provision of bariatric surgery in the Veterans Health Administration must account for obese veterans' co-morbidity burden and the geographically dispersed location of patients relative to Veterans Affairs (VA) bariatric centers. To evaluate a collaborative, integrated, interdisciplinary bariatric team of surgeons, bariatricians, psychologists, dieticians, and physical therapists working in a hub-and-spokes care model, for pre- and post-bariatric surgery assessment and management. This is a description of an interdisciplinary clinic and bariatric program at a VA healthcare system and a report on program evaluation findings. Retrospective data of a prospective database was abstracted. For program evaluation, we abstracted charts to characterize patient data and conducted a patient survey. Since 2009, 181 veterans have undergone bariatric surgery. Referrals came from 7 western U.S. states. Mean preoperative body mass index was 46 kg/m(2) (maximum 71). Mean age was 53 years, with 33% aged>60 years; 79% were male. Medical co-morbidity included diabetes (70%), hypertension (85%), and lower back or extremity joint pain (84%). A psychiatric diagnosis was present in 58%. At 12 months, follow-up was 81% and percent excess body mass index loss was 50.5%. Among 54 sequential clinic patients completing anonymous surveys, overall satisfaction with the interdisciplinary team approach and improved quality of life were high (98% and 94%, respectively). The integrated, interdisciplinary team approach using a hub-and-spokes model is well suited to the VA bariatric surgery population, with its heavy burden of medical and mental health co-morbidity and its system of geographically dispersed patients receiving treatment at specialty centers. As the VA seeks to expand the use of bariatric surgery as an option for obese veterans, interdisciplinary models crafted to address case complexity, care coordination, and long-term outcomes should be part of policy planning efforts. Published by

  14. Integrating and Choosing Research Approaches of Medical Social Science and Medical Humanities%医学社会科学及人文学科研究方法的整合与选择

    Institute of Scientific and Technical Information of China (English)

    冯泽永

    2012-01-01

    Applications of research approaches of medical social science and medical humanities are different for the difference in their research objects and participation extent. It is necessary for the two subjects to study the whole social phenomenon, social facts and its law, but also study the human who comprise society and organization and their subjective intention and actual experience. So the empirical and non-empirical approaches have to be integrated. "Science" and "humanity" must be viewed correctly through the integration.%医学社会科学及人文学科研究对象和参与程度的差异带来研究方法适用的差异.两类学科既要研究整体的社会现象、社会事实及其规律,又要研究组成社会和组织的人及其主观意向和真实体验,所以必须整合实证与非实证方法.整合中必须正确看待学科的“科学性”与“人文性”.

  15. Psychological maintenance as an integrated approach to prevention and correction of professional burning out of the medical staff

    Directory of Open Access Journals (Sweden)

    V. S. Kucher

    2014-01-01

    Full Text Available The syndrome of professional burning out is a complex of symptoms and signs evidenced in various negative psychic conditions at individual, interpersonal and organizational levels. It is formed owing to a long mismatch between the requirements of the professional environment and the resources of the expert. Analysis of the preventive and correctional programs as a psychological assistance showed insufficiency of such approach. Creation of preventive and correctional programs within psychological maintenance from the position of involution of professional resources, taking into account the theoretical - methodological basis (the concept, the purposes, tasks, system approach, criteria of efficiency and the subjective-personal resources of counteraction directed at activization to burning out at all stages of professional development is progressive.

  16. Integrated approaches to perceptual learning.

    Science.gov (United States)

    Jacobs, Robert A

    2010-04-01

    New technologies and new ways of thinking have recently led to rapid expansions in the study of perceptual learning. We describe three themes shared by many of the nine articles included in this topic on Integrated Approaches to Perceptual Learning. First, perceptual learning cannot be studied on its own because it is closely linked to other aspects of cognition, such as attention, working memory, decision making, and conceptual knowledge. Second, perceptual learning is sensitive to both the stimulus properties of the environment in which an observer exists and to the properties of the tasks that the observer needs to perform. Moreover, the environmental and task properties can be characterized through their statistical regularities. Finally, the study of perceptual learning has important implications for society, including implications for science education and medical rehabilitation. Contributed articles relevant to each theme are summarized.

  17. Integration of Medical Education and Healthcare Service

    Directory of Open Access Journals (Sweden)

    A Khojasteh

    2009-03-01

    Full Text Available "nThe Ministry of Health and Medical Education in Iran is responsible for public health, medical treatment and the management and planning of medical education, that is, training under supervision, of which expertise at all levels, from first degree to doctorate, is organized. The plan to create a health and treatment network and integrate medical education into healthcare system was designed to revolutionize the health machine in the country.

  18. Fingernail Injuries and NASA's Integrated Medical Model

    Science.gov (United States)

    Kerstman, Eric; Butler, Doug

    2008-01-01

    The goal of space medicine is to optimize both crew health and performance. Currently, expert opinion is primarily relied upon for decision-making regarding medical equipment and supplies flown in space. Evidence-based decisions are preferred due to mass and volume limitations and the expense of space flight. The Integrated Medical Model (IMM) is an attempt to move us in that direction!

  19. Thyroiditis: an integrated approach.

    Science.gov (United States)

    Sweeney, Lori B; Stewart, Christopher; Gaitonde, David Y

    2014-09-15

    Thyroiditis is a general term that encompasses several clinical disorders characterized by inflammation of the thyroid gland. The most common is Hashimoto thyroiditis; patients typically present with a nontender goiter, hypothyroidism, and an elevated thyroid peroxidase antibody level. Treatment with levothyroxine ameliorates the hypothyroidism and may reduce goiter size. Postpartum thyroiditis is transient or persistent thyroid dysfunction that occurs within one year of childbirth, miscarriage, or medical abortion. Release of preformed thyroid hormone into the bloodstream may result in hyperthyroidism. This may be followed by transient or permanent hypothyroidism as a result of depletion of thyroid hormone stores and destruction of thyroid hormone-producing cells. Patients should be monitored for changes in thyroid function. Beta blockers can treat symptoms in the initial hyperthyroid phase; in the subsequent hypothyroid phase, levothyroxine should be considered in women with a serum thyroid-stimulating hormone level greater than 10 mIU per L, or in women with a thyroid-stimulating hormone level of 4 to 10 mIU per L who are symptomatic or desire fertility. Subacute thyroiditis is a transient thyrotoxic state characterized by anterior neck pain, suppressed thyroid-stimulating hormone, and low radioactive iodine uptake on thyroid scanning. Many cases of subacute thyroiditis follow an upper respiratory viral illness, which is thought to trigger an inflammatory destruction of thyroid follicles. In most cases, the thyroid gland spontaneously resumes normal thyroid hormone production after several months. Treatment with high-dose acetylsalicylic acid or nonsteroidal anti-inflammatory drugs is directed toward relief of thyroid pain.

  20. Integrated Test Approach

    Science.gov (United States)

    Cotton, Will; Liechty, John

    2015-01-01

    This paper describes a testing methodology undertaken on the Facilities Development and Operations Contract (FDOC) by Lockheed Martin. The methodology was defined with the intent of reducing project schedule time to enable NASA's Johnson Space Center (JSC) to be able to deliver the Mission Control Center (MCC) 21 project as quickly as possible. 21 represents the 21st century where NASA JSC is updating its control center with new technology and operational concepts in order to support NASA customers wanting to use control center assets to support space vehicle operations. In collaboration with the NASA customer, a new test concept was conceived early during MCC21 project planning with the goal of reducing project delivery time. One enabler that could help reduce delivery time was testing. Within the project, testing was performed by two entities, software development responsible for subsystem testing and system test responsible for system integration testing. The MCC21 project took a deliberate review of testing to determine how it could be performed differently to realize an overall reduction in test time to support the goal of a more rapid project delivery.

  1. The implication of integrated training program for medical history education

    Directory of Open Access Journals (Sweden)

    Shun-Sheng Chen

    2015-02-01

    Full Text Available Background: A full spectrum of medical education requires not only clinical skills but also humanistic qualities in the medical professionals, which can be facilitated by an integrated training program. An integrated project was created to improve one's medical intellectual and communication competence and to enable them to become docents who can perform well, as well as for development of their humanitarian nature. The aim of this study was to suggest an integrated program that provided approaches for creating positive effects in medical history education. Methods: Taiwan Medical Museum conducted a project on medical history lessons and docent training program; 51 participants (24 male and 27 female attended this plan. Targets took pre-tests before lectures, attended courses of medical history, and then took post-tests. Next, they received a series of lessons on presentation skills and practiced for guiding performance. After all the training processes, the attendees succeeded in all evaluations in order to guide exhibition visitors. Data were analyzed using paired t test. Results: Two types of assessments were followed, i.e., cognitive examination and guiding practice, and both were related to good performance. Reliability (Cronbach's α was 0.737 for the cognitive examination and 0.87 for the guiding evaluation. It indicated that the integrated program for docent training resulted in a significant difference (p ≦ 0.0001. Conclusion: The participants demonstrated better achievement and knowledge acquisition through the entire process, which led to great performance when approached by the visitors. The whole project helped to shape up a good docent and to accumulate positive learning experiences for medical professionals as well. Therefore, an integrated program is recommended to medical history education in the future.

  2. The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

    Science.gov (United States)

    Kerstman, Eric; Minard, Charles; Saile, Lynn; deCarvalho, Mary Freire; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David

    2009-01-01

    The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.

  3. Integrated Approach to Managing Sustainability

    OpenAIRE

    László Berényi

    2013-01-01

    Achieving a higher level of sustainable development needs both individual and corporate efforts. An effective solution needs an integrated approach that allows the consideration of environmental and social values in addition to the economic interest. Additional management tools may be useful but sustaining them needs often untenable efforts from the organisations.This paper draws up a framework for how to integrate the values of sustainable development into the corporate activities by using c...

  4. Emphasizing humanities in medical education: Promoting the integration of medical scientific spirit and medical humanistic spirit.

    Science.gov (United States)

    Song, Peipei; Tang, Wei

    2017-05-23

    In the era of the biological-psychological-social medicine model, an ideal of modern medicine is to enhance the humanities in medical education, to foster medical talents with humanistic spirit, and to promote the integration of scientific spirit and humanistic spirit in medicine. Throughout the United States (US), United Kingdom (UK), other Western countries, and some Asian countries like Japan, many medical universities have already integrated the learning of medical humanities in their curricula and recognized their value. While in China, although medical education reform over the past decade has emphasized the topic of medical humanities to increase the professionalism of future physicians, the integration of medical humanity courses in medical universities has lagged behind the pace in Western countries. In addition, current courses in medical humanities were arbitrarily established due to a lack of organizational independence. For various reasons like a shortage of instructors, medical universities have failed to pay sufficient attention to medical humanities education given the urgent needs of society. The medical problems in contemporary Chinese society are not solely the purview of biomedical technology; what matters more is enhancing the humanities in medical education and fostering medical talents with humanistic spirit. Emphasizing the humanities in medical education and promoting the integration of medical scientific spirit and medical humanistic spirit have become one of the most pressing issues China must address. Greater attention should be paid to reasonable integration of humanities into the medical curriculum, creation of medical courses related to humanities and optimization of the curriculum, and actively allocating abundant teaching resources and exploring better methods of instruction.

  5. Integrating medical informatics into the medical undergraduate curriculum.

    Science.gov (United States)

    Khonsari, L S; Fabri, P J

    1997-01-01

    The advent of healthcare reform and the rapid application of new technologies have resulted in a paradigm shift in medical practice. Integrating medical Informatics into the full spectrum of medical education is a viral step toward implementing this new instructional model, a step required for the understanding and practice of modern medicine. We have developed an informatics curriculum, a new educational paradigm, and an intranet-based teaching module which are designed to enhance adult-learning principles, life-long self education, and evidence-based critical thinking. Thirty two, fourth year medical students have participated in a one month, full time, independent study focused on but not limited to four topics: mastering the windows-based environment, understanding hospital based information management systems, developing competence in using the internet/intranet and world wide web/HTML, and experiencing distance communication and TeleVideo networks. Each student has completed a clinically relevant independent study project utilizing technology mastered during the course. This initial curriculum offering was developed in conjunction with faculty from the College of Medicine, College of Engineering, College of Education, College of Business, College of Public Health. Florida Center of Instructional Technology, James A. Haley Veterans Hospital, Moffitt Cancer Center, Tampa General Hospital, GTE, Westshore Walk-in Clinic (paperless office), and the Florida Engineering Education Delivery System. Our second step toward the distributive integration process was the introduction of Medical Informatics to first, second and third year medical students. To date, these efforts have focused on undergraduate medical education. Our next step is to offer workshops in Informatics to college of medicine faculty, to residents in post graduate training programs (GME), and ultimately as a method of distance learning in continuing medical education (CME).

  6. Integrating environmental health into medical education.

    Science.gov (United States)

    Gehle, Kimberly S; Crawford, Jewel L; Hatcher, Michael T

    2011-10-01

    Although environmental factors contribute to more than 25% of all global disease, and toxic agents ranked fifth in underlying causes of U.S. deaths in 2000, environmental medicine education is largely omitted in the continuum of U.S. medical education. The paucity of specialists trained in environmental medicine (i.e., occupational medicine and other preventive medicine specialties and subspecialties), coupled with the lack of adequate general medical education on how to prevent, diagnose, refer, or treat patients exposed to hazardous substances in the environment, contributes to lost opportunities for primary prevention or early intervention to mitigate or minimize environmentally related disease burden. Survey findings of graduating medical students over the past few years have identified environmental health as a medical school topic area that can be improved. This article reflects a panel presentation on the challenge of including environmental health in general medical education. It was given at the 2010 "Patients and Populations: Public Health in Medical Education" conference cosponsored by the CDC and the American Association of Medical Colleges. A variety of educational strategies, models, and educational resources are presented that illustrate how recommended competency-based environmental health content can be integrated into medical education to better prepare medical students and physicians without specialized expertise in environmental medicine to provide or facilitate environmental preventive or curative patient care.

  7. Integrative medical education: educational strategies and preliminary evaluation of the Integrated Curriculum for Anthroposophic Medicine (ICURAM).

    Science.gov (United States)

    Scheffer, Christian; Tauschel, Diethard; Neumann, Melanie; Lutz, Gabriele; Cysarz, Dirk; Heusser, Peter; Edelhäuser, Friedrich

    2012-12-01

    the development and preliminary evaluation of a new medical program aimed at educating students in patient-centered integrative care and developing appropriate educational strategies. The Integrated Curriculum for Anthroposophic Medicine (ICURAM) was developed with modules on anthroposophic medicine integrated into the full 6 years of the regular medical curriculum. The educational strategy is the ESPRI(2)T approach, combining Exploratory learning, Supported participation, Patient-based learning, Reflective practice, Integrated learning, an Integrative approach and Team-based learning. The student participation, assessed based on the number of credit points earned per year (ctp/year) through the ICURAM (1 ctp=30 h workload), served as a preliminary indicator of student interest. Of the 412 55%medical students participated in the program: 16% full participation (≥ 4 ctp/year), 18% partial participation (1-3.99 ctp/year) and 22% occasional participation (0.25-0.99 ctp/year). The amount of additional workload taken on by students was between 7.8h/year for occasional participants, 33 h/year for partial participants and 84 h/year for full participants. More than half of medical students were willing to invest a significant amount of additional time in the optional program. An integrative medical curriculum with a student-centered educational strategy seems to be of interest to most medical students. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Indecisiveness: A Dynamic, Integrative Approach.

    Science.gov (United States)

    Johnson, Douglas Paul

    1990-01-01

    Responds to case of Sondra presented in Career Development Quarterly (September 1990). Suggests that her inability to decide on a career may be rooted in long-term personality style, poor ego strength, noisome family dynamics, and/or developmental delay. Recommends an integrative approach incorporating both personal and career counseling. (PVV)

  9. Multiaxial diagnosis: An integral approach

    OpenAIRE

    Adalberto Campo Arias

    2003-01-01

    All patients must be diagnosed with an integral, multiaxial or bio-psycho-social model. This approach makes possible understanding biological,personality, social, and cultural factor or background of ill people. Multiaxial perspective gives diagnosis more accurate and reliable. Moreover, it makes clinical practice more warm and humane.

  10. The integrative approach to psychiatry.

    Science.gov (United States)

    Lipowski, Z J

    1990-12-01

    From the early days of psychiatry as a distinct field of knowledge and clinical practice two competing approaches to the etiology and treatment of mental disorders have vied for dominance: the somatic and the psychic ("moral"). We are witnessing the same struggle today. To speak metaphorically, we can opt for either brainless or mindless psychiatry, as Szasz proposed. He failed to consider a third option, however, one that may be called an integrative approach. The latter is neither mindless nor brainless but rather encompasses both the mind and the brain in its theoretical and practical consideration. I will formulate the integrative approach in this paper and argue that it has a distinct advantage for both the study and treatment of mental disorders.

  11. A prototype integrated medical workstation environment

    NARCIS (Netherlands)

    E.M. van Mulligen (Erik); T. Timmers (Teun); F. van den Heuvel (F.); J.H. van Bemmel (Jan)

    1993-01-01

    markdownabstractAbstract In this paper the requirements, design, and implementation of a prototype integrated medical workstation environment are outlined. The aim of the workstation is to provide user-friendly, task-oriented support for clinicians, based on existing software and data. The prototy

  12. [WEB-based medical data mining integration].

    Science.gov (United States)

    Yao, Gang; Zhang, Xiaoxiang; Wang, Huoming

    2014-06-01

    An integration of medical data management system based on WEB and data mining tool is reportedly in this paper. In the application process of this system, web-based medical data mining user sends requests to the server by using client browser with http protocol, the commands are then received by the server and the server calls the data mining tools remote object for data processing, and the results are sent back to the customer browser through the http protocol and presented to the user. In order to prove the feasibility of the proposed solution, the test is done under the NET platform by using SAS and SPSS, and the detail steps are given. By the practical test, it was proved that the web-based data mining tool integration solutions proposed in this paper would have its broad prospects for development, which would open up a new route to the development of medical data mining.

  13. Using Zigbee to integrate medical devices.

    Science.gov (United States)

    Frehill, Paul; Chambers, Desmond; Rotariu, Cosmin

    2007-01-01

    Wirelessly enabling Medical Devices such as Vital Signs Monitors, Ventilators and Infusion Pumps allows central data collection. This paper discusses how data from these types of devices can be integrated into hospital systems using wireless sensor networking technology. By integrating devices you are protecting investment and opening up the possibility of networking with similar devices. In this context we present how Zigbee meets our requirements for bandwidth, power, security and mobility. We have examined the data throughputs for various medical devices, the requirement of data frequency, security of patient data and the logistics of moving patients while connected to devices. The paper describes a new tested architecture that allows this data to be seamlessly integrated into a User Interface or Healthcare Information System (HIS). The design supports the dynamic addition of new medical devices to the system that were previously unsupported by the system. To achieve this, the hardware design is kept generic and the software interface for different types of medical devices is well defined. These devices can also share the wireless resources with other types of sensors being developed in conjunction on this project such as wireless ECG (Electrocardiogram) and Pulse-Oximetry sensors.

  14. Resilience Approach for Medical Residents

    NARCIS (Netherlands)

    Bezemer, R.A.; Bos, E.W.

    2014-01-01

    Medical residents are in a vulnerable position. While still in training, they are responsible for patient care. They have a dependent relation with their supervisor and low decision latitude. An intervention was developed to increase individual and system resilience, addressing burnout, patient safe

  15. A framework for integration of heterogeneous medical imaging networks.

    Science.gov (United States)

    Viana-Ferreira, Carlos; Ribeiro, Luís S; Costa, Carlos

    2014-01-01

    Medical imaging is increasing its importance in matters of medical diagnosis and in treatment support. Much is due to computers that have revolutionized medical imaging not only in acquisition process but also in the way it is visualized, stored, exchanged and managed. Picture Archiving and Communication Systems (PACS) is an example of how medical imaging takes advantage of computers. To solve problems of interoperability of PACS and medical imaging equipment, the Digital Imaging and Communications in Medicine (DICOM) standard was defined and widely implemented in current solutions. More recently, the need to exchange medical data between distinct institutions resulted in Integrating the Healthcare Enterprise (IHE) initiative that contains a content profile especially conceived for medical imaging exchange: Cross Enterprise Document Sharing for imaging (XDS-i). Moreover, due to application requirements, many solutions developed private networks to support their services. For instance, some applications support enhanced query and retrieve over DICOM objects metadata. This paper proposes anintegration framework to medical imaging networks that provides protocols interoperability and data federation services. It is an extensible plugin system that supports standard approaches (DICOM and XDS-I), but is also capable of supporting private protocols. The framework is being used in the Dicoogle Open Source PACS.

  16. Clear Channel Assessment in Integrated Medical Environments

    Directory of Open Access Journals (Sweden)

    Hara Shinsuke

    2008-01-01

    Full Text Available Abstract Complementary WLAN and WPAN technologies as well as other wireless technologies will play a fundamental role in the medical environments to support ubiquitous healthcare delivery. This paper investigates clear channel assessment (CCA and its impact on the coexistence of WLAN (IEEE 802.11 high rate direct sequence spread spectrum (HR/DSSS PHY and WPAN (IEEE 802.15.4b in the 2.4 GHz industrial, scientific, and medical (ISM band. We derived closed-form expressions of both energy-based CCA and feature-based CCA. We qualified unequal sensing abilities between them and termed this inequality asymmetric CCA, which is different from the traditional "hidden node" or "exposed node" issues in the homogeneous network. The energy-based CCA was considered in the considered integrated medical environment because the 2.4 GHz ISM band is too crowded to apply feature-based CCA. The WPAN is oversensitive to the 802.11 HR/DSSS signals and the WLAN is insensitive to the 802.15.4b signals. Choosing an optimal CCA threshold requires some prior knowledge of the underlying signals. In the integrated medical environment we considered here, energy-based CCA can effectively avoid possible packet collisions when they are close within the "heterogeneous exclusive CCA range" (HECR. However, when they are separated beyond the HECR, WPAN can still sense the 802.11 HR/DSSS signals, but WLAN loses its sense to the 802.15.4b signals. The asymmetric CCA leads to WPAN traffic in a position secondary to WLAN traffic.

  17. Clear Channel Assessment in Integrated Medical Environments

    Directory of Open Access Journals (Sweden)

    Bin Zhen

    2008-03-01

    Full Text Available Complementary WLAN and WPAN technologies as well as other wireless technologies will play a fundamental role in the medical environments to support ubiquitous healthcare delivery. This paper investigates clear channel assessment (CCA and its impact on the coexistence of WLAN (IEEE 802.11 high rate direct sequence spread spectrum (HR/DSSS PHY and WPAN (IEEE 802.15.4b in the 2.4 GHz industrial, scientific, and medical (ISM band. We derived closed-form expressions of both energy-based CCA and feature-based CCA. We qualified unequal sensing abilities between them and termed this inequality asymmetric CCA, which is different from the traditional “hidden node” or “exposed node” issues in the homogeneous network. The energy-based CCA was considered in the considered integrated medical environment because the 2.4 GHz ISM band is too crowded to apply feature-based CCA. The WPAN is oversensitive to the 802.11 HR/DSSS signals and the WLAN is insensitive to the 802.15.4b signals. Choosing an optimal CCA threshold requires some prior knowledge of the underlying signals. In the integrated medical environment we considered here, energy-based CCA can effectively avoid possible packet collisions when they are close within the “heterogeneous exclusive CCA range” (HECR. However, when they are separated beyond the HECR, WPAN can still sense the 802.11 HR/DSSS signals, but WLAN loses its sense to the 802.15.4b signals. The asymmetric CCA leads to WPAN traffic in a position secondary to WLAN traffic.

  18. Pediatric asthma: an integrative approach to care.

    Science.gov (United States)

    Mark, John David

    2009-01-01

    Asthma in children and young adults is a complex disease with many different phenotypic expressions. Diagnosis is often made based on history and lung function including measuring airway reversibility. However, in children younger than 6 years of age, the diagnosis is more difficult because many children wheeze in the first 4-6 years of life, especially with viral infections. For those children, asthma treatment is often started empirically. Those who go on to develop chronic asthma most likely have a genetic predisposition and exposure to various environmental factors resulting in chronic inflammation of the lower respiratory tract. There are established national guidelines for diagnosing and treating asthma in children and adults. For persistent asthma, it is recommended that medications be taken on a regular basis after identifying and avoiding environmental triggers. Because many factors play a role in developing asthma in children, many nonmedical approaches to asthma and asthma-like conditions have been promoted even when the diagnosis is at times uncertain. The nonmedical approaches and therapies are often referred to as complementary and alternative medicine (CAM). This review will discuss the conventional therapies recommended for children with asthma in addition to CAM therapies, some of which have supporting scientific evidence. Integrating conventional and CAM therapies can prove to be an effective way to treat pediatric asthma, a common and chronic childhood lung disorder. A case is provided to illustrate how such an integrative approach was used in the successful treatment of a child with moderate persistent asthma.

  19. An Integrated Health Care Model in Medical Education: Interviews with Faculty and Administrators.

    Science.gov (United States)

    Tresolini, Carol P.; Shugars, Daniel A.

    1994-01-01

    Faculty and administrators of 22 medical schools were interviewed for their insights into development of an approach to health care and medical education that integrates psychosocial and biomedical perspectives. Results suggest medical curricula should address development of physicians' knowledge, attitudes, and skills in relationships with both…

  20. Integrated Medical Model Project - Overview and Summary of Historical Application

    Science.gov (United States)

    Myers, J.; Boley, L.; Butler, D.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.; hide

    2015-01-01

    Introduction: The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project. Methods: Figure 1 [see document] illustrates the IMM modeling system and scenario process. As illustrated, the IMM computational architecture is based on Probabilistic Risk Assessment techniques. Nineteen assumptions and limitations define the IMM application domain. Scenario definitions include crew medical attributes and mission specific details. The IMM forecasts probabilities of loss of crew life (LOCL), evacuation (EVAC), quality time lost during the mission, number of medical resources utilized and the number and type of medical events by combining scenario information with in-flight, analog, and terrestrial medical information stored in the iMED. In addition, the metrics provide the integrated information necessary to estimate optimized in-flight medical kit contents under constraints of mass and volume or acceptable level of mission risk. Results and Conclusions

  1. Machine learning approaches in medical image analysis

    DEFF Research Database (Denmark)

    de Bruijne, Marleen

    2016-01-01

    Machine learning approaches are increasingly successful in image-based diagnosis, disease prognosis, and risk assessment. This paper highlights new research directions and discusses three main challenges related to machine learning in medical imaging: coping with variation in imaging protocols......, learning from weak labels, and interpretation and evaluation of results....

  2. Integrating surgical robots into the next medical toolkit.

    Science.gov (United States)

    Lai, Fuji; Entin, Eileen

    2006-01-01

    Surgical robots hold much promise for revolutionizing the field of surgery and improving surgical care. However, despite the potential advantages they offer, there are multiple barriers to adoption and integration into practice that may prevent these systems from realizing their full potential benefit. This study elucidated some of the most salient considerations that need to be addressed for integration of new technologies such as robotic systems into the operating room of the future as it evolves into a complex system of systems. We conducted in-depth interviews with operating room team members and other stakeholders to identify potential barriers in areas of workflow, teamwork, training, clinical acceptance, and human-system interaction. The findings of this study will inform an approach for the design and integration of robotics and related computer-assisted technologies into the next medical toolkit for "computer-enhanced surgery" to improve patient safety and healthcare quality.

  3. Integrated VCOs for Medical Implant Transceivers

    Directory of Open Access Journals (Sweden)

    Ahmet Tekin

    2008-01-01

    Full Text Available The 402–405 MHz medical implant communication service (MICS band has recently been allocated by the US Federal Communication Commission (FCC with the potential to replace the low-frequency inductive coupling techniques in implantable devices. This band was particularly chosen to provide full-integration, low-power, faster data transfer, and longer communication range. This paper investigates the design of a voltage-controlled oscillator (VCO that will be an essential building block of such wireless implantable devices operating in the MICS service band. Three different integrated quadrature VCOs that meet the requirements of the MICS standard are designed in 0.18 μm TSMC CMOS process to propose an optimum choice. Their performances in terms of power consumption, die area, linearity, and phase noise are compared. The fabricated VCOs are a four-stage differential ring VCO, an LC tank VCO directly loaded with a poly-phase filter, and an 800 MHz LC tank VCO with a high-frequency master-slave divider. All three architectures target a VCO gain of Kvco = 15 MHz/V with 3 calibration control and 2 frequency-shift keying (FSK control signals and are designed for 1.5 V supply voltage in a 0.18-μm standard CMOS process.

  4. From integrated control to integrated farming, an experimental approach

    NARCIS (Netherlands)

    Vereijken, P.H.

    1989-01-01

    Integrated control or integrated pest management (IPM), as envisaged originally, is not being practised to any large extent in arable farming, notwithstanding considerable research efforts. The reasons for this are discussed. A more basic approach called integrated farming is suggested. Preliminary

  5. Pediatric Integrative Medicine Approaches to Attention Deficit Hyperactivity Disorder (ADHD

    Directory of Open Access Journals (Sweden)

    Anna Esparham

    2014-08-01

    Full Text Available Attention deficit hyperactivity disorder (ADHD is the most common neuropsychiatric disorder in children and is increasing in prevalence. There has also been a related increase in prescribing stimulant medication despite some controversy whether ADHD medication makes a lasting difference in school performance or achievement. Families who are apprehensive about side effects and with concerns for efficacy of medication pursue integrative medicine as an alternative or adjunct to pharmacologic and cognitive behavioral treatment approaches. Integrative medicine incorporates evidence-based medicine, both conventional and complementary and alternative therapies, to deliver personalized care to the patient, emphasizing diet, nutrients, gut health, and environmental influences as a means to decrease symptoms associated with chronic disorders. Pediatric integrative medicine practitioners are increasing in number throughout the United States because of improvement in patient health outcomes. However, limited funding and poor research design interfere with generalizable treatment approaches utilizing integrative medicine. The use of research designs originally intended for drugs and procedures are not suitable for many integrative medicine approaches. This article serves to highlight integrative medicine approaches in use today for children with ADHD, including dietary therapies, nutritional supplements, environmental hygiene, and neurofeedback.

  6. Stochastic integrals: a combinatorial approach

    OpenAIRE

    Rota, Gian-Carlo; Wallstrom, Timothy C.

    1997-01-01

    A combinatorial definition of multiple stochastic integrals is given in the setting of random measures. It is shown that some properties of such stochastic integrals, formerly known to hold in special cases, are instances of combinatorial identities on the lattice of partitions of a set. The notion of stochastic sequences of binomial type is introduced as a generalization of special polynomial sequences occuring in stochastic integration, such as Hermite, Poisson–Charlier an...

  7. The Integrated Medical Model: Outcomes from Independent Review

    Science.gov (United States)

    Myers, J.; Garcia, Y.; Griffin, D.; Arellano, J.; Boley, L.; Goodenow, D. A.; Kerstman, E.; Reyes, D.; Saile, L.; Walton, M.; hide

    2017-01-01

    In 2016, the Integrated Medical Model (IMM) v4.0 underwent an extensive external review in preparation for transition to an operational status. In order to insure impartiality of the review process, the Exploration Medical Capabilities Element of NASA's Human Research Program convened the review through the Systems Review Office at NASA Goddard Space Flight Center (GSFC). The review board convened by GSFC consisted of persons from both NASA and academia with expertise in the fields of statistics, epidemiology, modeling, software development, aerospace medicine, and project management (see Figure 1). The board reviewed software and code standards, as well as evidence pedigree associated with both the input and outcomes information. The board also assesses the models verification, validation, sensitivity to parameters and ability to answer operational questions. This talk will discuss the processes for designing the review, how the review progressed and the findings from the board, as well as summarize the IMM project responses to those findings. Overall, the board found that the IMM is scientifically sound, represents a necessary, comprehensive approach to identifying medical and environmental risks facing astronauts in long duration missions and is an excellent tool for communication between engineers and physicians. The board also found IMM and its customer(s) should convene an additional review of the IMM data sources and to develop a sustainable approach to augment, peer review, and maintain the information utilized in the IMM. The board found this is critically important because medical knowledge continues to evolve. Delivery of IMM v4.0 to the Crew Health and Safety (CHS) Program will occur in the 2017. Once delivered for operational decision support, IMM v4.0 will provide CHS with additional quantitative capability in to assess astronaut medical risks and required medical capabilities to help drive down overall mission risks.

  8. 'Medical ethics'--an alternative approach.

    Science.gov (United States)

    Haldane, J J

    1986-09-01

    Contemporary medical ethics is generally concerned with the application of ethical theory to medico-moral dilemmas and with the critical analysis of the concepts of medicine. This paper presents an alternative programme: the development of a medical philosophy which, by taking as its starting point the two questions: what is man? and, what constitutes goodness in life? offers an account of health as one of the primary concepts of value. This view of the subject resembles that implied by ancient theories of goodness, and in later sections of the paper it is shown how Aristotle points us towards a coherent theory of human nature as psycho-physical, which overcomes the inadequacies of dualism and physicalist reductionism. What is on offer therefore, is the prospect of an integrated account of human nature and of what constitutes its flourishing: to be healthy is to be an active unity-of-parts in equilibrium.

  9. [Humanities in medical education: between reduction and integration].

    Science.gov (United States)

    Han, Taehee

    2015-09-01

    Reductive logic has been a major reasoning style in development of modern biomedical sciences. However, when "medical humanities" is developed by reductive reasoning, integrative and holistic values of humanities tend to be weakened. In that sense, identity and significance of "medical humanities" continue to be controversial despite of its literal clarity. Humanities in medical education should be established by strengthening humanistic and socialistic aspects of regular medical curriculum as well as developing individual "medical humanities" programs.

  10. Caprock integrity analysis in thermal operations: an integrated geomechanics approach

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Safdar; Han, Hongxue; Ansari, Sajjad; Vishteh, Morteza; Khosravi, Nader [Schlumberger Data and Consulting Services (Canada)

    2011-07-01

    In heavy oil fields, thermal processes such as steam assisted gravity drainage (SAGD) and cyclic steam simulation (CSS) are used to recover oil. Unfortunately these methods can induce problems of caprock integrity. It is commonly thought that to maintain caprock integrity, the net injection pressure should be kept under the fracture pressure as measured by mini-fracturing tests but cases have shown that failures can occur below this pressure. This paper aimed at presenting a new approach based on geomechanics to evaluate caprock integrity in thermal processes. A study case was conducted on an SAGD pad development in Northern Alberta. Results confirmed that caprock integrity cannot be guaranteed by injecting steam at a pressure lower than the fracture pressure. In addition the geomechanical model can be used to take measures to avoid catastrophic events. A new integrated geomechanical approach for caprock integrity in thermal operations was developed herein and successfully tested in a field study.

  11. [Medical tourism and travel - an interdisciplinary approach].

    Science.gov (United States)

    Freyer, W; Kim, B-S

    2014-01-01

    Medical tourism (or medical travel, international patient service, cross-border or global health care) is a new current phenomenon with increasing relevance for the two disciplines of medicine and tourism. Both sides hope to improve their reputation and image, as well as to increase their revenues and rate of employment; furthermore, they want to provide better care and service for patients and tourists: Medical tourism can close the gap of the health care system at home, providing better quality, quicker access and cheaper procedures abroad, also with treatments, not - legally - available in the sending country. For the tourism sector it broadens the variety of tourism products and supply of the host country and combines medical treatments and recovery with an attractive stay in a tourism destination for patients and their companions. But in spite of all popularity of this new type of tourism and treatment, there is quite a lack of theory and academic analysis. This article outlines the status quo of scientific research both from a medical and tourism point of view. This interdisciplinary method of approach is based mainly on a state-of-the art review of the current literature. There is a great need for more scientific research in the field of medical tourism, based on the common knowledge of both disciplines tourism and medicine. First there is neither an internationally agreed definition nor a common methodology for data collection. So the real impact of touristic and medical services both for the source and for the receiving countries is un-known and imprecise. Second the internal processes of the health system have to be adapted to the needs of international patients, e. g., medical fee schedule, billing, language, inter-cultural qualifications of the staff. Moreover the whole service chain has to be taken into account, especially the pre- and post-processes, which mostly start or end abroad. Here quality standards as well as accreditations are current

  12. [Homeopathy: a humanistic approach to medical practice].

    Science.gov (United States)

    Teixeira, Marcus Zulian

    2007-01-01

    During the last decade, the traditional medical model has endeavoured to retrieve an improvement in the patient-physician relationship by means of propositions for humanization in the areas of education, medical care and policies. To enhance holistic characteristics of non-conventional practices in health, the incorporation of several aspects of humanities in understanding the process of the individual's illness, stressing that the physician's interest in aspects apparently not related to the impaired organ (history of the patients life, personality, interests, etc.) should be added to the technical and less humanized consultation. Since homeopathy embraces this wide semiological approach as inherent practice, using the totality of characteristic symptoms to evaluate organic unbalance and choose means of treatment, homeopathic clinical practice can significantly contribute to humanism in medicine.

  13. An Integrated Software System for Medical Equipment Management

    Science.gov (United States)

    2007-11-02

    1 of 4 AN INTEGRATED SOFTWARE SYSTEM FOR MEDICAL EQUIPMENT MANAGEMENT Z. Bliznakov, N. Pallikarakis Department of Medical Physics , School of...Project Number Task Number Work Unit Number Performing Organization Name(s) and Address(es) Department of Medical Physics School of Medicine

  14. [Consistent presentation of medical images based on CPI integration profile].

    Science.gov (United States)

    Jiang, Tao; An, Ji-ye; Chen, Zhong-yong; Lu, Xu-dong; Duan, Hui-long

    2007-11-01

    Because of different display parameters and other factors, digital medical images present different display states in different section offices of a hospital. Based on CPI integration profile of IHE, this paper implements the consistent presentation of medical images, and it is helpful for doctors to carry out medical treatments of teamwork.

  15. Path Integral Approach to Atomic Collisions

    Science.gov (United States)

    Harris, Allison

    2016-09-01

    The Path Integral technique is an alternative formulation of quantum mechanics that is based on a Lagrangian approach. In its exact form, it is completely equivalent to the Hamiltonian-based Schrödinger equation approach. Developed by Feynman in the 1940's, following inspiration from Dirac, the path integral approach has been widely used in high energy physics, quantum field theory, and statistical mechanics. However, only in limited cases has the path integral approach been applied to quantum mechanical few-body scattering. We present a theoretical and computational development of the path integral method for use in the study of atomic collisions. Preliminary results are presented for some simple systems. Ultimately, this approach will be applied to few-body ion-atom collisions. Work supported by NSF grant PHY-1505217.

  16. The Use of the Integrated Medical Model for Forecasting and Mitigating Medical Risks for a Near-Earth Asteroid Mission

    Science.gov (United States)

    Kerstman, Eric; Saile, Lynn; Freire de Carvalho, Mary; Myers, Jerry; Walton, Marlei; Butler, Douglas; Lopez, Vilma

    2011-01-01

    Introduction The Integrated Medical Model (IMM) is a decision support tool that is useful to space flight mission managers and medical system designers in assessing risks and optimizing medical systems. The IMM employs an evidence-based, probabilistic risk assessment (PRA) approach within the operational constraints of space flight. Methods Stochastic computational methods are used to forecast probability distributions of medical events, crew health metrics, medical resource utilization, and probability estimates of medical evacuation and loss of crew life. The IMM can also optimize medical kits within the constraints of mass and volume for specified missions. The IMM was used to forecast medical evacuation and loss of crew life probabilities, as well as crew health metrics for a near-earth asteroid (NEA) mission. An optimized medical kit for this mission was proposed based on the IMM simulation. Discussion The IMM can provide information to the space program regarding medical risks, including crew medical impairment, medical evacuation and loss of crew life. This information is valuable to mission managers and the space medicine community in assessing risk and developing mitigation strategies. Exploration missions such as NEA missions will have significant mass and volume constraints applied to the medical system. Appropriate allocation of medical resources will be critical to mission success. The IMM capability of optimizing medical systems based on specific crew and mission profiles will be advantageous to medical system designers. Conclusion The IMM is a decision support tool that can provide estimates of the impact of medical events on human space flight missions, such as crew impairment, evacuation, and loss of crew life. It can be used to support the development of mitigation strategies and to propose optimized medical systems for specified space flight missions. Learning Objectives The audience will learn how an evidence-based decision support tool can be

  17. Operationalizing the integrated landscape approach in practice

    Directory of Open Access Journals (Sweden)

    Olivia E. Freeman

    2015-03-01

    the process of taking a landscape approach. Drawing on a review of the literature, we identify and discuss three different kinds of landscape approaches: using the landscape scale, a sectoral landscape approach, and an integrated landscape approach. Focusing on an integrated landscape approach, we examine five concepts to help characterize landscape approaches: multifunctionality, transdisciplinarity, participation, complexity, and sustainability. For each term, a continuum of application exists. To help improve and move the integrated landscape approach more toward operationalization, more focus needs to be placed on the process of taking the approach. Although the process can be implemented in a range of ways, in a more integrated approach it will require explicitly defined objectives as well as a clear understanding of what is meant by multifunctionality and sustainability. It will also require collaborative participation, transdisciplinarity/cross-sectoral approaches, managing for adaptive capacity, and applying an iterative process to address the inherent complexity within the system. Although these concepts are not new, we present continuums on which they can exist, allowing for clarification and distinctions to be made regarding what it means to take a landscape approach.

  18. The integrated curriculum in medical education: AMEE Guide No. 96.

    Science.gov (United States)

    Brauer, David G; Ferguson, Kristi J

    2015-04-01

    The popularity of the term "integrated curriculum" has grown immensely in medical education over the last two decades, but what does this term mean and how do we go about its design, implementation, and evaluation? Definitions and application of the term vary greatly in the literature, spanning from the integration of content within a single lecture to the integration of a medical school's comprehensive curriculum. Taking into account the integrated curriculum's historic and evolving base of knowledge and theory, its support from many national medical education organizations, and the ever-increasing body of published examples, we deem it necessary to present a guide to review and promote further development of the integrated curriculum movement in medical education with an international perspective. We introduce the history and theory behind integration and provide theoretical models alongside published examples of common variations of an integrated curriculum. In addition, we identify three areas of particular need when developing an ideal integrated curriculum, leading us to propose the use of a new, clarified definition of "integrated curriculum", and offer a review of strategies to evaluate the impact of an integrated curriculum on the learner. This Guide is presented to assist educators in the design, implementation, and evaluation of a thoroughly integrated medical school curriculum.

  19. Integrated software system for improving medical equipment management.

    Science.gov (United States)

    Bliznakov, Z; Pappous, G; Bliznakova, K; Pallikarakis, N

    2003-01-01

    The evolution of biomedical technology has led to an extraordinary use of medical devices in health care delivery. During the last decade, clinical engineering departments (CEDs) turned toward computerization and application of specific software systems for medical equipment management in order to improve their services and monitor outcomes. Recently, much emphasis has been given to patient safety. Through its Medical Device Directives, the European Union has required all member nations to use a vigilance system to prevent the reoccurrence of adverse events that could lead to injuries or death of patients or personnel as a result of equipment malfunction or improper use. The World Health Organization also has made this issue a high priority and has prepared a number of actions and recommendations. In the present workplace, a new integrated, Windows-oriented system is proposed, addressing all tasks of CEDs but also offering a global approach to their management needs, including vigilance. The system architecture is based on a star model, consisting of a central core module and peripheral units. Its development has been based on the integration of 3 software modules, each one addressing specific predefined tasks. The main features of this system include equipment acquisition and replacement management, inventory archiving and monitoring, follow up on scheduled maintenance, corrective maintenance, user training, data analysis, and reports. It also incorporates vigilance monitoring and information exchange for adverse events, together with a specific application for quality-control procedures. The system offers clinical engineers the ability to monitor and evaluate the quality and cost-effectiveness of the service provided by means of quality and cost indicators. Particular emphasis has been placed on the use of harmonized standards with regard to medical device nomenclature and classification. The system's practical applications have been demonstrated through a pilot

  20. Approaches of researches in medical geography in Poland and Ukraine

    Science.gov (United States)

    Pantylej, Wiktoria

    2008-01-01

    This paper deals with the historical review of medical geography in the world, in Poland and in Ukraine. There are different approaches in medical geography: according to the research subject (ecological and economic approaches) and according to the current affairs of research (approach concerns sexuality, the age of the population and accordingly, accessibility of health care services to the population). To the author's mind, the most perspective approaches in medical geography in Poland and Ukraine are as follows: - integrative - dedicated to the health status of the population in connection with the quality and life level; - mathematical-statistical - connected with the problem of synthetic indexes of health status of the populations and factors influencing it, and with the problem of economic value of health and life of the population; - social-economic - the analysis of the influence of socioeconomic factors (such as wealth measure, rate of unemployment, work conditions and others) on public health; - ecological - connected with the researches dedicated to the analysis of environmental impact on public health status of the population; - demographical - the analysis of demographical factors of forming public health status; - social-psychological - health culture of the population, perception of the own health/morbidity and health care systems existing in different countries.

  1. Beyond biological monitoring: an integrated approach

    NARCIS (Netherlands)

    Verdonschot, P.F.M.

    2006-01-01

    Concluding discussion ‘Beyond Biological Monitoring: An Integrated Approach’ of the section New tools and strategies for river ecology evaluation – presents decision making on what constitutes a significant environmental change; predictive modelling approaches; evaluating fluvial functioning (FFI),

  2. Integration Platform As Central Service Of Data Replication In Distributed Medical System

    Directory of Open Access Journals (Sweden)

    Wiesław Wajs

    2007-01-01

    Full Text Available The paper presents the application of Java Integration Platform (JIP to data replicationin the distributed medical system. After an introductory part on the medical system’s architecture,the focus shifts to a comparison of different approaches that exist with regard totransferring data between the system’s components. A description is given of the historicaldata processing and of the whole area of the JIP application to the medical system.

  3. Agricultural drainage: Towards an integrated approach

    NARCIS (Netherlands)

    Abdeldayem, S.; Hoevenaars, J.; Mollinga, P.P.; Scheuman, W.; Slootweg, R.; Steenbergen, van F.

    2005-01-01

    Drainage needs to reclaim its rightful position as an indispensable element in the integrated management of land and water. An integrated approach to drainage can be developed by means of systematic mapping of the functions of natural resources systems (goods and services) and the values attributed

  4. Teaching Online: An Integrated Approach

    Science.gov (United States)

    Thomas, Christian

    2012-03-01

    Teaching online is becoming more popular and many web-based tools are available for both traditional and online courses. Web applets, videos, hi-resolution images, c. are available to illustrate and reinforce content. Most are generally used as separate material in the classroom or from a separate web page, not tied directly to the course text. Web pages amalgamate resources based on topics, but are generally not directly linked to the material covered in a textbook. Some textbooks come with separate CDROMs containing extra materials, but these are an add-on. I will present an example of an integrated course text with materials linked directly into the text. This method allows students to look at the illustration at the appropriate time --- when it is relevant to the material they are reading. I will also discuss the benefits of using these materials in an introductory astronomy course.

  5. Assessment of Medical Risks and Optimization of their Management using Integrated Medical Model

    Science.gov (United States)

    Fitts, Mary A.; Madurai, Siram; Butler, Doug; Kerstman, Eric; Risin, Diana

    2008-01-01

    The Integrated Medical Model (IMM) Project is a software-based technique that will identify and quantify the medical needs and health risks of exploration crew members during space flight and evaluate the effectiveness of potential mitigation strategies. The IMM Project employs an evidence-based approach that will quantify probability and consequences of defined in-flight medical risks, mitigation strategies, and tactics to optimize crew member health. Using stochastic techniques, the IMM will ultimately inform decision makers at both programmatic and institutional levels and will enable objective assessment of crew health and optimization of mission success using data from relevant cohort populations and from the astronaut population. The objectives of the project include: 1) identification and documentation of conditions that may occur during exploration missions (Baseline Medical Conditions List [BMCL), 2) assessment of the likelihood of conditions in the BMCL occurring during exploration missions (incidence rate), 3) determination of the risk associated with these conditions and quantify in terms of end states (Loss of Crew, Loss of Mission, Evacuation), 4) optimization of in-flight hardware mass, volume, power, bandwidth and cost for a given level of risk or uncertainty, and .. validation of the methodologies used.

  6. An integral approach to substance abuse.

    Science.gov (United States)

    Amodia, Diana S; Cano, Carol; Eliason, Michele J

    2005-12-01

    There is a pressing need in the substance abuse field for more comprehensive models of etiology and treatment that address the complex issues of addiction, including the biological, social, cultural, spiritual and developmental needs of individuals and groups. This article presents a theoretical framework for an integral approach to substance abuse that expands on the existing biopsychosocial model. One contribution of the model is an integrated approach to spirituality from a cross-cultural perspective. This integral approach examines substance abuse etiology and treatment from a four-quadrant perspective adapted from the work of Ken Wilber, and incorporates concepts from integrative medicine and transpersonal psychology/psychiatry. Implications of the model are explored.

  7. Overlap between empathy, teamwork and integrative approach to patient care.

    Science.gov (United States)

    Hojat, Mohammadreza; Bianco, Joseph A; Mann, Douglas; Massello, David; Calabrese, Leonard H

    2014-10-14

    Abstract Background: Empathy, teamwork and an integrative approach to patient care share common denominators such as interpersonal skills and understanding patients' concerns. Thus, a significant overlap among measures of empathy, teamwork and integrative approach to patient care is expected. Aim: This study examined the magnitude of overlap (shared variance) among three measures of empathy, teamwork and an integrative approach to patient care. Methods: Three-hundred seventy-three medical students completed the Jefferson Scale of Empathy (JSE), the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC) and Integrative Patient Care (IPC). Results: Significant overlaps were found among the three measures (p < 0.01), ranging from 13% (r = 0.36), between JSAPNC and IPC, to 18% (r = 0.42), between JSE and JSAPNC, and 30% (r = 0.55) between JSE and IPC for the total sample. Pattern of findings was similar for men and women. In a multiple regression model, a significant multiple correlation (R = 0.60, p < 0.01) was obtained in correlating scores on the JSE with the JSAPNC, and IPC scores, controlling for gender effect (men = 0 and women = 1). Conclusions: The significant links between empathy, teamwork and IPC support the common denominator assumption. The findings that IPC shares common variance with empathy and teamwork have implications for medical education curriculum, suggesting that implementation of integrative patient care can improve empathic engagement in patient care and orientation toward teamwork.

  8. Integrated Approaches On Archaeo-Geophysical Data

    Science.gov (United States)

    Kucukdemirci, M.; Piro, S.; Zamuner, D.; Ozer, E.

    2015-12-01

    Key words: Ground Penetrating Radar (GPR), Magnetometry, Geophysical Data Integration, Principal Component Analyse (PCA), Aizanoi Archaeological Site An application of geophysical integration methods which often appealed are divided into two classes as qualitative and quantitative approaches. This work focused on the application of quantitative integration approaches, which involve the mathematical and statistical integration techniques, on the archaeo-geophysical data obtained in Aizanoi Archaeological Site,Turkey. Two geophysical methods were applied as Ground Penetrating Radar (GPR) and Magnetometry for archaeological prospection on the selected archaeological site. After basic data processing of each geophysical method, the mathematical approaches of Sums and Products and the statistical approach of Principal Component Analysis (PCA) have been applied for the integration. These integration approches were first tested on synthetic digital images before application to field data. Then the same approaches were applied to 2D magnetic maps and 2D GPR time slices which were obtained on the same unit grids in the archaeological site. Initially, the geophysical data were examined individually by referencing with archeological maps and informations obtained from archaeologists and some important structures as possible walls, roads and relics were determined. The results of all integration approaches provided very important and different details about the anomalies related to archaeological features. By using all those applications, integrated images can provide complementary informations as well about the archaeological relics under the ground. Acknowledgements The authors would like to thanks to Scientific and Technological Research Council of Turkey (TUBITAK), Fellowship for Visiting Scientists Programme for their support, Istanbul University Scientific Research Project Fund, (Project.No:12302) and archaeologist team of Aizanoi Archaeological site for their support

  9. Paradigms and pragmatism: approaches to medical statistics.

    Science.gov (United States)

    Healy, M J

    2000-01-01

    Until recently, the dominant philosophy of science was that due to Karl Popper, with its doctrine that the proper task of science was the formulation of hypotheses followed by attempts at refuting them. In spite of the close analogy with significance testing, these ideas do not fit well with the practice of medical statistics. The same can be said of the later philosophy of Thomas Kuhn, who maintains that science proceeds by way of revolutionary upheavals separated by periods of relatively pedestrian research which are governed by what Kuhn refers to as paradigms. Through there have been paradigm shifts in the history of statistics, a degree of continuity can also be discerned. A current paradigm shift is embodied in the spread of Bayesian ideas. It may be that a future paradigm will emphasise the pragmatic approach to statistics that is associated with the name of Daniel Schwartz.

  10. Integrating Communicative Approaches with Traditional Approaches in ELT

    Institute of Scientific and Technical Information of China (English)

    陈超

    2013-01-01

    Traditional y, English teaching in China is dominated by a teacher-centered, grammar-translation and audio-lingual method and an emphasis on rote learning. In an attempt to find out what are the most appropriate teaching methods for Chinese students in schools, the paper presents that the best method is to integrate communicative approaches to the teaching of English with traditional Chinese methods. It shows that integrating communicative approaches with the traditional approaches can real y help the students develop their communicative competence.

  11. Integrating ultrasound into modern medical curricula.

    Science.gov (United States)

    Patel, Shilpan G; Benninger, Brion; Mirjalili, S Ali

    2017-05-01

    Ultrasonography is widely practiced in many disciplines. It is becoming increasingly important to design well-structured curricula to introduce imaging to students during medical school. This review aims to analyze the literature for evidence of how ultrasonography has been incorporated into anatomy education in medical school curricula worldwide. A literature search was conducted using multiple databases with the keywords: "Ultrasound OR Ultrasonographic examination*" and "Medical student* OR Undergraduate teaching* OR Medical education*" and "Anatomy* OR Living anatomy* OR Real-time anatomy.*" This review found that ultrasound curricula vary in stage of implementation, course length, number of sessions offered to students as well as staffing and additional course components. Most courses consisted of didactic lectures supplemented with demonstration sessions and/or hands-on ultrasound scanning sessions. The stage of course implementation tended to depend on the aim of the course; introductory courses were offered earlier in a student's career. Most courses improved student confidence and exam performance, and more junior students tended to benefit more from learning anatomy with ultrasound guidance rather than learning clinical examination skills. Students tended to prefer smaller groups when learning ultrasound to get more access to using the machines themselves. Ultrasonography is an important skill, which should be taught to medical students early in their careers as it facilitates anatomical education and is clinically relevant, though further objective research required to support the use of ultrasound education as a tool to improve clinical examination skills in medical students. Clin. Anat. 30:452-460, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  12. Integrative Virology for Senior Medical Students.

    Science.gov (United States)

    Koment, Roger W.

    1991-01-01

    The article describes a senior elective in virology developed at the University of South Dakota School of Medicine. Students work independently through a series of course units, selecting 12 study topics from a catalog of 35 topics in medical virology and discussing their reading daily with the professor. (DB)

  13. Integrative Virology for Senior Medical Students.

    Science.gov (United States)

    Koment, Roger W.

    1991-01-01

    The article describes a senior elective in virology developed at the University of South Dakota School of Medicine. Students work independently through a series of course units, selecting 12 study topics from a catalog of 35 topics in medical virology and discussing their reading daily with the professor. (DB)

  14. Numerical Inversion of Integral Equations for Medical Imaging and Geophysics

    Science.gov (United States)

    1988-12-13

    Equations for Medical Imaging and Geophysics (Unclassified) 12 PERSONAL AUTHOR(S) Frank Stenger 13a. TYPE OF REPORT 13b TIME COVERED 14. DATE OF REPORT...9r~S NUMERICAL INVERSION OF INTEGRAL EQUATIONS FOR MEDICAL IMAGING AND GEOPHYSICS FINAL REPORT AUTHOR OF REPORT: Frank Stenger December 13, 1988

  15. Dressed coordinates: The path-integral approach

    Science.gov (United States)

    Casana, R.; Flores-Hidalgo, G.; Pimentel, B. M.

    2007-02-01

    The recently introduced dressed coordinates are studied in the path-integral approach. These coordinates are defined in the context of a harmonic oscillator linearly coupled to massless scalar field and it is shown that in this model the dressed coordinates appear as a coordinate transformation preserving the path-integral functional measure. The analysis also generalizes the sum rules established in a previous work.

  16. Blind integrity verification of medical images.

    Science.gov (United States)

    Huang, Hui; Coatrieux, Gouenou; Shu, Huazhong; Luo, Limin; Roux, Christian

    2012-11-01

    This work presents the first method of digital blind forensics within the medical imaging field with the objective to detect whether an image has been modified by some processing (e.g. filtering, lossy compression and so on). It compares two image features: the Histogram statistics of Reorganized Block-based Discrete cosine transform coefficients (HRBD), originally proposed for steganalysis purposes, and the Histogram statistics of Reorganized Block-based Tchebichef moments (HRBT). Both features serve as input of a set of SVM classifiers built in order to discriminate tampered images from original ones as well as to identify the nature of the global modification one image may have undergone. Performance evaluation, conducted in application to different medical image modalities, shows that these image features can help, independently or jointly, to blindly distinguish image processing or modifications with a detection rate greater than 70%. They also underline the complementarity of these features.

  17. Integrated Cloud-Based Services for Medical Workflow Systems

    Directory of Open Access Journals (Sweden)

    Gharbi Nada

    2016-12-01

    Full Text Available Recent years have witnessed significant progress of workflow systems in different business areas. However, in the medical domain, the workflow systems are comparatively scarcely researched. In the medical domain, the workflows are as important as in other areas. In fact, the flow of information in the healthcare industry is even more critical than it is in other industries. Workflow can provide a new way of looking at how processes and procedures are completed in particular medical systems, and it can help improve the decision-making in these systems. Despite potential capabilities of workflow systems, medical systems still often perceive critical challenges in maintaining patient medical information that results in the difficulties in accessing patient data by different systems. In this paper, a new cloud-based service-oriented architecture is proposed. This architecture will support a medical workflow system integrated with cloud services aligned with medical standards to improve the healthcare system.

  18. Grazing incidence angle based sensing approach integrated with fiber-optic Fourier transform infrared (FO-FTIR) spectroscopy for remote and label-free detection of medical device contaminations

    Energy Technology Data Exchange (ETDEWEB)

    Hassan, Moinuddin, E-mail: moinuddin.hassan@fda.hhs.gov; Ilev, Ilko [Optical Therapeutics and Medical Nanophotonics Laboratory, Division of Biomedical Physics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryland 20993 (United States)

    2014-10-15

    Contamination of medical devices has become a critical and prevalent public health safety concern since medical devices are being increasingly used in clinical practices for diagnostics, therapeutics and medical implants. The development of effective sensing methods for real-time detection of pathogenic contamination is needed to prevent and reduce the spread of infections to patients and the healthcare community. In this study, a hollow-core fiber-optic Fourier transform infrared spectroscopy methodology employing a grazing incidence angle based sensing approach (FO-FTIR-GIA) was developed for detection of various biochemical contaminants on medical device surfaces. We demonstrated the sensitivity of FO-FTIR-GIA sensing approach for non-contact and label-free detection of contaminants such as lipopolysaccharide from various surface materials relevant to medical device. The proposed sensing system can detect at a minimum loading concentration of approximately 0.7 μg/cm{sup 2}. The FO-FTIR-GIA has the potential for the detection of unwanted pathogen in real time.

  19. On-line integration of computer controlled diagnostic devices and medical information systems in undergraduate medical physics education for physicians.

    Science.gov (United States)

    Hanus, Josef; Nosek, Tomas; Zahora, Jiri; Bezrouk, Ales; Masin, Vladimir

    2013-01-01

    We designed and evaluated an innovative computer-aided-learning environment based on the on-line integration of computer controlled medical diagnostic devices and a medical information system for use in the preclinical medical physics education of medical students. Our learning system simulates the actual clinical environment in a hospital or primary care unit. It uses a commercial medical information system for on-line storage and processing of clinical type data acquired during physics laboratory classes. Every student adopts two roles, the role of 'patient' and the role of 'physician'. As a 'physician' the student operates the medical devices to clinically assess 'patient' colleagues and records all results in an electronic 'patient' record. We also introduced an innovative approach to the use of supportive education materials, based on the methods of adaptive e-learning. A survey of student feedback is included and statistically evaluated. The results from the student feedback confirm the positive response of the latter to this novel implementation of medical physics and informatics in preclinical education. This approach not only significantly improves learning of medical physics and informatics skills but has the added advantage that it facilitates students' transition from preclinical to clinical subjects.

  20. Medical technology in India: Tracing policy approaches.

    Science.gov (United States)

    Chakravarthi, Indira

    2013-01-01

    Medical devices and equipment have become an indispensable part of modern medical practice. Yet these medical technologies receive scant attention in the Indian context, both at the health policy level and as an area of study. There has been little attempt to systematically address the issue of equipment based medical technologies and how to regulate their use. There is paucity of primary data on the kind of medical equipment and techniques being introduced, on their need and relative usefulness, reliability, patterns of utilization, on their production, procurement, distribution, costs, and accessibility. This article reviews some of the policy issues relating to equipment based medical technology in India, in light of the specific choices and policies made during and after the colonial period in favour of modern medicine and a technology-based public health system, attempts at self-sufficiency and the current international environment with respect to the medical equipment and health-care industry.

  1. Advancing Instructional Communication: Integrating a Biosocial Approach

    Science.gov (United States)

    Horan, Sean M.; Afifi, Tamara D.

    2014-01-01

    Celebrating 100 years of the National Communication Association necessitates that, as we commemorate our past, we also look toward our future. As part of a larger conversation about the future of instructional communication, this essay reinvestigates the importance of integrating biosocial approaches into instructional communication research. In…

  2. The Foresee Approach to Integrated ESL Instruction.

    Science.gov (United States)

    Kidd, Richard; Marquardson, Brenda

    1997-01-01

    Describes the Foresee Approach to integrating academic content, language, and learning instruction in English as a Second Language (ESL) from kindergarten to grade 12 or in mainstream/part ESL classrooms. The Foresee Model includes theoretical and practical constituents and guides the formulation of instructional objectives in the three target…

  3. Integrated Approach to User Account Management

    Science.gov (United States)

    Kesselman, Glenn; Smith, William

    2007-01-01

    IT environments consist of both Windows and other platforms. Providing user account management for this model has become increasingly diffi cult. If Microsoft#s Active Directory could be enhanced to extend a W indows identity for authentication services for Unix, Linux, Java and Macintosh systems, then an integrated approach to user account manag ement could be realized.

  4. Medical device integration using mobile telecommunications infrastructure.

    Science.gov (United States)

    Moorman, Bridget A; Cockle, Richard A

    2013-01-01

    Financial pressures, an aging population, and a rising number of patients with chronic diseases, have encouraged the use of remote monitoring technologies. This usually entails at least one physiological parameter measurement for a clinician. Mobile telecommunication technologies lend themselves to this functionality, and in some cases, avoid some of the issues encountered with device integration. Moreover, the inherent characteristics of the mobile telecommunications infrastructure allow a coupling of business and clinical functions that were not possible before. Table I compares and contrasts some key aspect of device integration in and out of a healthcare facility. An HTM professional may be part of the team that acquires and/or manages a system using a mobile telecommunications technology. It is important for HTM professionals to ensure the data is in a standard format so that the interfaces across this system don't become brittle and break easily if one part changes. Moreover, the security and safety considerations of the system and the data should be a primary consideration in and y purchase, with attention given to the proper environmental and encryption mechanisms. Clinical engineers and other HTM professionals are unique in that they understand the patient/clinician/device interface and the need to ensure its safety and effectiveness regardless of geographical environment.

  5. A semantic medical multimedia retrieval approach using ontology information hiding.

    Science.gov (United States)

    Guo, Kehua; Zhang, Shigeng

    2013-01-01

    Searching useful information from unstructured medical multimedia data has been a difficult problem in information retrieval. This paper reports an effective semantic medical multimedia retrieval approach which can reflect the users' query intent. Firstly, semantic annotations will be given to the multimedia documents in the medical multimedia database. Secondly, the ontology that represented semantic information will be hidden in the head of the multimedia documents. The main innovations of this approach are cross-type retrieval support and semantic information preservation. Experimental results indicate a good precision and efficiency of our approach for medical multimedia retrieval in comparison with some traditional approaches.

  6. Student Perceptions of Independent versus Facilitated Small Group Learning Approaches to Compressed Medical Anatomy Education

    Science.gov (United States)

    Whelan, Alexander; Leddy, John J.; Mindra, Sean; Matthew Hughes, J. D.; El-Bialy, Safaa; Ramnanan, Christopher J.

    2016-01-01

    The purpose of this study was to compare student perceptions regarding two, small group learning approaches to compressed (46.5 prosection-based laboratory hours), integrated anatomy education at the University of Ottawa medical program. In the facilitated active learning (FAL) approach, tutors engage students and are expected to enable and…

  7. Digital patient records and the medical desktop: an integrated physician workstation for medical informatics training.

    OpenAIRE

    Litt, H. I.; Loonsk, J. W.

    1992-01-01

    The Institute of Medicine and others have advocated a shift from a paper-based to an electronic medical record and many authorities have advanced the concept of a physician workstation that can provide access to a wide variety of both clinically and reference oriented medical information. We have developed a working model of an integrated physician workstation based on a graphically oriented "Medical Desktop," for personal computers. This system gives the user access to much of the informatio...

  8. How Does Iranian's Legal System Protect Human Vulnerability and Personal Integrity in Medical Research?

    Science.gov (United States)

    Karoubi, Mohammad Taghi; Akhondi, Mohammad Mehdi

    2011-01-01

    The astonishing advance of medical science in recent decades has had endless advantages for humans, including improved level of health, prevention of disease and advances in treatment. These advances depend to a great extent on conducting continuous research. However, besides its enormous advantages, the sole interest of medical science undermines the principles of respect for human vulnerability and personal integrity, in both positive and negative approaches. The positive approach refers to the people who participate in research and practice, while the negative approach refers to people who are deprived of research and practice. The authors of this work, based on legal or moral grounds try to analyse the tension between the principle of respect for human vulnerability and personal integrity and the interest of medical science. Undoubtedly, in applying scientific knowledge and medical practice human vulnerability should be taken into account. In this regard, especially vulnerable individuals and groups should be protected and the personal integrity of such individuals respected. In the light of the merits of Islamic law, this paper is designed to examine the significance of the principles of human vulnerability and personal integrity in medical research by studying the international documents as formalised by UNESCO in order to explore the place of these principles in the Iranian legal system. PMID:23408269

  9. Holistic integrative medicine: toward a new era of medical advancement.

    Science.gov (United States)

    Fan, Daiming

    2017-03-01

    Medicine has encountered unprecedented problems associated with changes in nature, society, and environment, as well as with new human quests for survival, longevity, and health. In the meantime, the development of medicine is facing challenges that resulted from the over-division and specialization of disciplines and the fragmentation of medical knowledge. To construct a new medical system that is more suitable for human health and disease treatment, holistic integrative medicine (HIM), which regards the human body as a holistic entity, organically integrates the most advanced knowledge and theories in each medical field and the most effective practices in various clinical specialties to revise and adjust on the basis of social, environmental, and psychological conditions. HIM is the inevitable and necessary direction for the future development of medicine. In this article, we illustrated the connotation of HIM, the differences between HIM and other medical conceptions, and the practice of HIM in recent years.

  10. Integral, measure and derivative a unified approach

    CERN Document Server

    Shilov, G E

    2012-01-01

    This graduate-level textbook and monograph defines the functions of a real variable through consistent use of the Daniell scheme, offering a rare and useful alternative to customary approaches. The treatment can be understood by any reader with a solid background in advanced calculus, and it features many problems with hints and answers. ""The exposition is fresh and sophisticated,"" declared Sci-Tech Book News, ""and will engage the interest of accomplished mathematicians."" Part one is devoted to the integral, moving from the Reimann integral and step functions to a general theory, and obta

  11. Limitations of Western Medicine and Models of Integration Between Medical Systems.

    Science.gov (United States)

    Attena, Francesco

    2016-05-01

    This article analyzes two major limitations of Western medicine: maturity and incompleteness. From this viewpoint, Western medicine is considered an incomplete system for the explanation of living matter. Therefore, through appropriate integration with other medical systems, in particular nonconventional approaches, its knowledge base and interpretations may be widened. This article presents possible models of integration of Western medicine with homeopathy, the latter being viewed as representative of all complementary and alternative medicine. To compare the two, a medical system was classified into three levels through which it is possible to distinguish between different medical systems: epistemological (first level), theoretical (second level), and operational (third level). These levels are based on the characterization of any medical system according to, respectively, a reference paradigm, a theory on the functioning of living matter, and clinical practice. The three levels are consistent and closely consequential in the sense that from epistemology derives theory, and from theory derives clinical practice. Within operational integration, four models were identified: contemporary, alternative, sequential, and opportunistic. Theoretical integration involves an explanation of living systems covering simultaneously the molecular and physical mechanisms of functioning living matter. Epistemological integration provides a more thorough and comprehensive explanation of the epistemic concepts of indeterminism, holism, and vitalism to complement the reductionist approach of Western medicine; concepts much discussed by Western medicine while lacking the epistemologic basis for their emplacement. Epistemologic integration could be reached with or without a true paradigm shift and, in the latter, through a model of fusion or subsumption.

  12. Integration of Computers into the Medical School Curriculum: An Example from a Microbiology Course.

    Science.gov (United States)

    Platt, Mark W.; And Others

    1994-01-01

    While the use of computers has become widespread in recent years, a unified, integrated approach to their use in the medical school curriculum has not yet emerged. Describes a program at the University of New Mexico that will phase-in computerization of its curriculum beginning in the fall of 1993. (LZ)

  13. Chinese integrative medicine:inclusion of a Chinese medicine programme in a conventional medical institute

    Institute of Scientific and Technical Information of China (English)

    Hai-Yong Chen; Yibin Feng; Lixing Lao

    2014-01-01

    To meet community demands with optimal Chinese and conventional medical treatment, the University of Hong Kong is promoting integrative medicine by developing Chinese medicine programmes that train students of both Western and Chinese medicine. The programmes emphasize multi-disciplinary training and interaction between the two therapeutic approaches, enabling students to establish reliable, consistent, and respectful mutual cooperation in their future careers.

  14. Medical Device Integration Model Based on the Internet of Things.

    Science.gov (United States)

    Hao, Aiyu; Wang, Ling

    2015-01-01

    At present, hospitals in our country have basically established the HIS system, which manages registration, treatment, and charge, among many others, of patients. During treatment, patients need to use medical devices repeatedly to acquire all sorts of inspection data. Currently, the output data of the medical devices are often manually input into information system, which is easy to get wrong or easy to cause mismatches between inspection reports and patients. For some small hospitals of which information construction is still relatively weak, the information generated by the devices is still presented in the form of paper reports. When doctors or patients want to have access to the data at a given time again, they can only look at the paper files. Data integration between medical devices has long been a difficult problem for the medical information system, because the data from medical devices are lack of mandatory unified global standards and have outstanding heterogeneity of devices. In order to protect their own interests, manufacturers use special protocols, etc., thus causing medical decices to still be the "lonely island" of hospital information system. Besides, unfocused application of the data will lead to failure to achieve a reasonable distribution of medical resources. With the deepening of IT construction in hospitals, medical information systems will be bound to develop towards mobile applications, intelligent analysis, and interconnection and interworking, on the premise that there is an effective medical device integration (MDI) technology. To this end, this paper presents a MDI model based on the Internet of Things (IoT). Through abstract classification, this model is able to extract the common characteristics of the devices, resolve the heterogeneous differences between them, and employ a unified protocol to integrate data between devices. And by the IoT technology, it realizes interconnection network of devices and conducts associate matching

  15. Attitudes of medical students toward the practice and teaching of integrative medicine

    Institute of Scientific and Technical Information of China (English)

    Gerard Flaherty; Jenny Fitzgibbon; Peter Cantillon

    2015-01-01

    The General Medical Council encourages the integration of complementary and alternative medicine (CAM) teaching into basic medical education. We wished to explore the attitudes of medical students to CAM and its inclusion in their undergraduate curriculum. Medical students were invited to complete the validated Integrative Medicine Attitude Questionnaire (IMAQ) and to state whether they considered it appropriate for them to learn about CAM in medical school. The questionnaire was completed by 308 students (65.8% response rate). CAM had been received by a majority of respondents and their families. Participants believed that doctors with knowledge of CAM provide better patient care and that it is desirable for physicians to exploit the placebo effect. Most students expressed the view that doctors should be able to answer patients’ questions about herbal medicines. There was a belief that patients should be warned to avoid using supplements which have not undergone rigorous testing. Students who were current or previous users of CAM or whose family members used CAM had higher total IMAQ scores and openness subscale scores than those who did not report use of CAM. Two-hundred and nine (68%) students expressed a desire to study CAM as part of their medical curriculum. This study reveals a positive attitude towards a holistic approach to patient care which embraces CAM. Medical students believe that integrative medicine should be taught in medical school.

  16. Integrating and promoting medical podcasts into the library collection.

    Science.gov (United States)

    Kraft, Michelle

    2007-01-01

    Podcasts offer a way for medical professionals to listen to current information in medicine from an iPod, MP3 player, handheld device, or computer. As podcasts become more popular, libraries may be interested in integrating programs into the library collection. South Pointe Medical Library evaluated medical podcasts relevant to the scope of the library collection and explored methods for finding and organizing such programs in ways that are efficient for both the librarian and the patron. doi:10.1300/J115v26n01_03.

  17. A Burning Experiment Study of an Integral Medical Waste Incinerator

    OpenAIRE

    Xie, Rong; Lu, Jidong; Li,Jie

    2010-01-01

    Mass burning of the medical waste is becoming attr active in China because Chinese government has banned landfilling of medical waste. Many advantages can be found in this method, such as reduction in waste vol-ume, destruction of pathogens and transformation of waste into the form of ash. However, the medical waste with high moisture in China is not suitable to be trea ted in the present direct mass burning incinerators. In this paper, a novel integral incinera tor is developed with combinin...

  18. Mentoring by design: integrating medical professional competencies into bioengineering and medical physics graduate training.

    Science.gov (United States)

    Woods, Kendra V; Peek, Kathryn E; Richards-Kortum, Rebecca

    2014-12-01

    Many students in bioengineering and medical physics doctoral programs plan careers in translational research. However, while such students generally have strong quantitative abilities, they often lack experience with the culture, communication norms, and practice of bedside medicine. This may limit students' ability to function as members of multidisciplinary translational research teams. To improve students' preparation for careers in cancer translational research, we developed and implemented a mentoring program that is integrated with students' doctoral studies and aims to promote competencies in communication, biomedical ethics, teamwork, altruism, multiculturalism, and accountability. Throughout the program, patient-centered approaches and professional competencies are presented as foundational to optimal clinical care and integral to translational research. Mentoring is conducted by senior biomedical faculty and administrators and includes didactic teaching, online learning, laboratory mini-courses, clinical practicums, and multidisciplinary patient planning conferences (year 1); student development and facilitation of problem-based patient cases (year 2); and individualized mentoring based on research problems and progress toward degree completion (years 3-5). Each phase includes formative and summative evaluations. Nineteen students entered the program from 2009 through 2011. On periodic anonymous surveys, the most recent in September 2013, students indicated that the program substantially improved their knowledge of cancer biology, cancer medicine, and academic medicine; that the mentors were knowledgeable, good teachers, and dedicated to students; and that the program motivated them to become well-rounded scientists and scholars. We believe this program can be modified and disseminated to other graduate research and professional health care programs.

  19. Boundary conditions: The path integral approach

    Energy Technology Data Exchange (ETDEWEB)

    Asorey, M [Departamento de Fisica Teorica, Universidad de Zaragoza 50009 Zaragoza (Spain); Clemente-Gallardo, J [BIFI, Universidad de Zaragoza, 50009 Zaragoza (Spain); Munoz-Castaneda, J M [Departamento de Fisica Teorica, Universidad de Zaragoza 50009 Zaragoza (Spain)

    2007-11-15

    The path integral approach to quantum mechanics requires a substantial generalisation to describe the dynamics of systems confined to bounded domains. Nonlocal boundary conditions can be introduced in Feynman's approach by means of boundary amplitude distributions and complex phases to describe the quantum dynamics in terms of the classical trajectories. The different prescriptions involve only trajectories reaching the boundary and correspond to different choices of boundary conditions of selfadjoint extensions of the Hamiltonian. One dimensional particle dynamics is analysed in detail.

  20. ENPEP: An integrated approach to energy planning

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, B.P.; Cirillo, R.R.; Buehring, W.A.

    1992-01-01

    Many models have been developed to analyze various aspects of the energy system. The Energy and Power Evaluation Program (ENPEP) is a set of microcomputer-based energy planning tools that are designed to provide an integrated analysis capability. ENPEP begins with a macroeconomic analysis, develops an energy demand forecast based on this analysis, carries out an integrated supply/demand analysis for the entire energy system, evaluates the electric system component of the energy system in detail, and determines the impacts of alternative configurations. This approach is an enhancement of existing techniques in that it places emphasis on looking at the electric system as an integral part of the entire energy supply system. Also, it explicitly considers the impacts the power system has on the rest of the energy system and on the economy as a whole.

  1. ENPEP: An integrated approach to energy planning

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, B.P.; Cirillo, R.R.; Buehring, W.A.

    1992-09-01

    Many models have been developed to analyze various aspects of the energy system. The Energy and Power Evaluation Program (ENPEP) is a set of microcomputer-based energy planning tools that are designed to provide an integrated analysis capability. ENPEP begins with a macroeconomic analysis, develops an energy demand forecast based on this analysis, carries out an integrated supply/demand analysis for the entire energy system, evaluates the electric system component of the energy system in detail, and determines the impacts of alternative configurations. This approach is an enhancement of existing techniques in that it places emphasis on looking at the electric system as an integral part of the entire energy supply system. Also, it explicitly considers the impacts the power system has on the rest of the energy system and on the economy as a whole.

  2. Introduction to solid mechanics an integrated approach

    CERN Document Server

    Lubliner, Jacob

    2017-01-01

    This expanded second edition presents in one text the concepts and processes covered in statics and mechanics of materials curricula following a systematic, topically integrated approach. Building on the novel pedagogy of fusing concepts covered in traditional undergraduate courses in rigid-body statics and deformable body mechanics, rather than simply grafting them together, this new edition develops further the authors’ very original treatment of solid mechanics with additional figures, an elaboration on selected solved problems, and additional text as well as a new subsection on viscoelasticity in response to students’ feedback. Introduction to Solid Mechanics: An Integrated Approach, Second Edition, offers a holistic treatment of the depth and breadth of solid mechanics and the inter-relationships of its underlying concepts. Proceeding from first principles to applications, the book stands as a whole greater than the sum of its parts.  .

  3. Control theory and psychopathology: an integrative approach.

    Science.gov (United States)

    Mansell, Warren

    2005-06-01

    Perceptual control theory (PCT; Powers, 1973) is presented and adapted as a framework to understand the causes, maintenance, and treatment of psychological disorders. PCT provides dynamic, working models based on the principle that goal-directed activity arises from a hierarchy of negative feedback loops that control perception through control of the environment. The theory proposes that psychological distress arises from the unresolved conflict between goals. The present paper integrates PCT, control theory, and self-regulatory approaches to psychopathology and psychotherapy and recent empirical findings, particularly in the field of cognitive therapy. The approach aims to offer fresh insights into the role of goal conflict, automatic processes, imagery, perceptual distortion, and loss of control in psychological disorders. Implications for psychological therapy are discussed, including an integration of the existing work on the assessment of control profiles and the use of assertive versus yielding modes of control.

  4. Word Parts and a Systematic Approach to Medical Vocabulary Learning

    Institute of Scientific and Technical Information of China (English)

    田俊英; 蒋东坡

    2016-01-01

    This paper outlines four word parts of medical vocabulary—roots,prefixes,suffixes,and linking vowels(usually o)and put forward a systematic approach to medical vocabulary learning.To develop a high degree of proficiency in learning medical vocabulary,it is advisable to learn the basic roots and affixes so as to make informed guesses regarding the meanings of unfamiliar medical vocabulary.

  5. An approach to develop sustainable medical devices

    OpenAIRE

    Hede, Shantesh Digambar

    2013-01-01

    Tese de doutoramento Bioengenharia The development and commercialization of contemporary Medical Devices is inherently of a multidisciplinary nature. Consequently, they have to undergo a stringent regulatory compliance procedure in conformity with an ever increasingly fierce and competitive business environment. Throughout the product life cycle, medical devices would significantly consume renewable as well as non-renewable resources and as a result exert a substantial socia...

  6. Closed-loop approach for situation awareness of medical devices and operating room infrastructure

    Directory of Open Access Journals (Sweden)

    Rockstroh Max

    2015-09-01

    Full Text Available In recent years, approaches for information and control integration in the digital operating room have emerged. A major step towards an intelligent operating room and a cooperative technical environment would be autonomous adaptation of medical devices and systems to the surgical workflow. The OR staff should be freed from information seeking and maintenance tasks. We propose a closed-loop concept integrating workflow monitoring, processing and (semi-automatic interaction to bridge the gap between OR integration of medical devices and workflow-related information management.

  7. Efficient integration method for fictitious domain approaches

    Science.gov (United States)

    Duczek, Sascha; Gabbert, Ulrich

    2015-10-01

    In the current article, we present an efficient and accurate numerical method for the integration of the system matrices in fictitious domain approaches such as the finite cell method (FCM). In the framework of the FCM, the physical domain is embedded in a geometrically larger domain of simple shape which is discretized using a regular Cartesian grid of cells. Therefore, a spacetree-based adaptive quadrature technique is normally deployed to resolve the geometry of the structure. Depending on the complexity of the structure under investigation this method accounts for most of the computational effort. To reduce the computational costs for computing the system matrices an efficient quadrature scheme based on the divergence theorem (Gauß-Ostrogradsky theorem) is proposed. Using this theorem the dimension of the integral is reduced by one, i.e. instead of solving the integral for the whole domain only its contour needs to be considered. In the current paper, we present the general principles of the integration method and its implementation. The results to several two-dimensional benchmark problems highlight its properties. The efficiency of the proposed method is compared to conventional spacetree-based integration techniques.

  8. An Architectural Approach for Building Medical Ontologies

    Directory of Open Access Journals (Sweden)

    Mircea Adrian FOCŞA

    2016-07-01

    Full Text Available Starting from a use case scenario related to the Electronic Medical Record (EMR information retrieval, this paper proposes several design principles for an ontology-based EMR system, which will allow the physician to perform a semantic search about a specific body structure or zone/space (affected, explored or treated. The research starts from analyzing the information requirements of the family doctors related to the medical history of their patients. By interviewing a group of family doctors, a set of common questions have been identified and modeled as one generic question. The key terms from this generic question then became the building blocks of an ontology, which was further built incrementally and constantly adjusted depending on the query response (design pattern by querying. Elements from other terminologies/ontologies have been reused thus facilitating interoperability with similar constructions. As a result of this research, we tested and proposed for adoption several basic modeling principles for medical ontologies, among them, the particularities of part-whole relations for body regions/spaces and anatomical components, the requirements for propagation of the medical activities from one class to an upper or subsequent class. These modeling principles have a good degree of generality and could be taken into consideration for building any medical ontology.

  9. Integrating the Medical Home into the EHDI Process

    Science.gov (United States)

    Munoz, Karen F.; Nelson, Lauri; Bradham, Tamala S.; Hoffman, Jeff; Houston, K. Todd

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. Related to how the medical home is integrated into the EHDI process, 273 items were listed by 48 coordinators, and themes were identified…

  10. Integrating the Medical Home into the EHDI Process

    Science.gov (United States)

    Munoz, Karen F.; Nelson, Lauri; Bradham, Tamala S.; Hoffman, Jeff; Houston, K. Todd

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. Related to how the medical home is integrated into the EHDI process, 273 items were listed by 48 coordinators, and themes were identified…

  11. Integration of Medical Education in Medical Services: A Cross Sectional Study

    Directory of Open Access Journals (Sweden)

    Razavi Seyed Mansour

    2009-10-01

    Full Text Available Ministry of health and Medical Education (MOH&ME with the goals of attaining the comprehensive self sufficiency in medical fields and accountability of universities to public health needs were established in Iran in 1985. After that, ministry moved one step towards the integration of medical education into the health services in 1994. A dilemma about returning the system into the prior situation was increased in 2002, during which the parliament tried to change the situation toward disintegration. We have studied the attitudes of key academic persons regarding the segregation of medical universities (MOH&ME establishment and "Integration" of medical education into the health delivery system. A descriptive, cross sectional and correlation study was conducted on 556 universities staffs in 11 universities throughout the country. We applied a questionnaire with 28 questions on 5 axes. The analytical test used in this study was Pearson chi-square. The most understudied staffs, agreed with Integration philosophy. They believed that, although it seems the quality of medical education has declined, but some effective factors such as increasing admitted students, irregular increasing of universities and self controlling of educational hospitals, deficit of educational budget and other reasons were the main effective causes in this declining of quality, and most of them believed that the reintegration of MOH&ME into the ministry of sciences organization will not benefit for the country. This study has presented some reasons of proposed declining the quality of medical education and some suggestions for development of present system.

  12. Integrated approach for hybrid rocket technology development

    Science.gov (United States)

    Barato, Francesco; Bellomo, Nicolas; Pavarin, Daniele

    2016-11-01

    Hybrid rocket motors tend generally to be simple from a mechanical point of view but difficult to optimize because of their complex and still not well understood cross-coupled physics. This paper addresses the previous issue presenting the integrated approach established at University of Padua to develop hybrid rocket based systems. The methodology tightly combines together system analysis and design, numerical modeling from elementary to sophisticated CFD, and experimental testing done with incremental philosophy. As an example of the approach, the paper presents the experience done in the successful development of a hybrid rocket booster designed for rocket assisted take off operations. It is thought that following the proposed approach and selecting carefully the most promising applications it is possible to finally exploit the major advantages of hybrid rocket motors as safety, simplicity, low cost and reliability.

  13. SOA approach for integration of departmental systems.

    Science.gov (United States)

    Itälä, Timo; Ukkola, Jari; Virtanen, Aino; Mykkänen, Juha

    2008-01-01

    In this paper a unified method for integration of departmental systems into the main systems of a healthcare organization is described. The approach is based on combining Business Process Modeling (BPM) and Service Oriented Architecture (SOA) methods and technologies. A top-down approach is used for modeling the care process and supporting care services which in turn are decomposed down to such a level of granularity that they can be described and implemented as web services described with Web Services Description Language (WSDL) documents. Then a bottom-up approach is used for wrapping the existing departmental systems and their interfaces into web services using Enterprise Service Bus (ESB). Finally the orchestration of the services is described using executable Business Process Execution Language (BPEL) code.

  14. The Requirements for Ontologies in Medical Data Integration: A Case Study

    CERN Document Server

    Anjum, Ashiq; Branson, Andrew; Hauer, Tamas; McClatchey, Richard; Munir, Kamran; Rogulin, Dmitry; Shamdasani, Jetendr

    2007-01-01

    Evidence-based medicine is critically dependent on three sources of information: a medical knowledge base, the patients medical record and knowledge of available resources, including where appropriate, clinical protocols. Patient data is often scattered in a variety of databases and may, in a distributed model, be held across several disparate repositories. Consequently addressing the needs of an evidence-based medicine community presents issues of biomedical data integration, clinical interpretation and knowledge management. This paper outlines how the Health-e-Child project has approached the challenge of requirements specification for (bio-) medical data integration, from the level of cellular data, through disease to that of patient and population. The approach is illuminated through the requirements elicitation and analysis of Juvenile Idiopathic Arthritis (JIA), one of three diseases being studied in the EC-funded Health-e-Child project.

  15. Overview of an Integrated Medical System for Exploration Missions

    Science.gov (United States)

    Watkins, Sharmila; Rubin, David

    2013-01-01

    The Exploration Medical Capability (ExMC) element of the NASA Human Research Program (HRP) is charged with addressing the risk of unacceptable health and mission outcomes due to limitations of inflight medical capabilities. The Exploration Medical System Demonstration (EMSD) is a project within the ExMC element aimed at reducing this risk by improving the medical capabilities available for exploration missions. The EMSD project will demonstrate, on the ground and on ISS, the integration of several components felt to be essential to the delivery of medical care during long ]duration missions outside of low Earth orbit. The components of the EMSD include the electronic medical record, assisted medical procedure software, medical consumables tracking technology and RFID ] tagged consumables, video conferencing capability, ultrasound device and probes (ground demonstration only), peripheral biosensors, and the software to allow communication among the various components (middleware). This presentation seeks to inform our international partners of the goals and objectives of the EMSD and to foster collaboration opportunities related to this and future projects.

  16. Constructing a knowledge-based database for dermatological integrative medical information.

    Science.gov (United States)

    Shin, Jeeyoung; Jo, Yunju; Bae, Hyunsu; Hong, Moochang; Shin, Minkyu; Kim, Yangseok

    2013-01-01

    Recently, overuse of steroids and immunosuppressive drugs has produced incurable dermatological health problems. Traditional medical approaches have been studied for alternative solutions. However, accessing relevant information is difficult given the differences in information for western medicine (WM) and traditional medicine (TM). Therefore, an integrated medical information infrastructure must be utilized to bridge western and traditional treatments. In this study, WM and TM information was collected based on literature searches and information from internet databases on dermatological issues. Additionally, definitions for unified terminology and disease categorization based on individual cases were generated. Also a searchable database system was established that may be a possible model system for integrating both WM and TM medical information on dermatological conditions. Such a system will yield benefits for researchers and facilitate the best possible medical solutions for patients. The DIMI is freely available online.

  17. Integration of evidence based medicine into a medical curriculum.

    Science.gov (United States)

    Tamim, H M; Ferwana, M; Al Banyan, E; Al Alwan, I; Hajeer, A H

    2009-09-20

    The College of Medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) was established in January 2004. The four-year curriculum was based on the Problem Based Learning (PBL) format and involved the web-based graduate medical program adopted from the University of Sydney, Australia. At KSAU-HS, one additional semester was added to the beginning of this curriculum to prepare the students in English language skills, PBL, Information Technology and Evidence Based Medicine (EBM). EBM is part of the Personal and Professional Development (PPD) theme of the medical curriculum and is integrated into each stage of the medical curriculum. These modifications of the University of Sydney curriculum are presented here as a model of EBM integration into a college of medicine curriculum.

  18. Integration of Evidence Based Medicine into a Medical Curriculum

    Science.gov (United States)

    Tamim, H M; Ferwana, M; Al Banyan, E; Al Alwan, I; Hajeer, AH

    2009-01-01

    The College of Medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) was established in January 2004. The four-year curriculum was based on the Problem Based Learning (PBL) format and involved the web-based graduate medical program adopted from the University of Sydney, Australia. At KSAU-HS, one additional semester was added to the beginning of this curriculum to prepare the students in English language skills, PBL, Information Technology and Evidence Based Medicine (EBM). EBM is part of the Personal and Professional Development (PPD) theme of the medical curriculum and is integrated into each stage of the medical curriculum. These modifications of the University of Sydney curriculum are presented here as a model of EBM integration into a college of medicine curriculum. PMID:20165529

  19. Delivering a pathology curriculum in an integrated medical course.

    Science.gov (United States)

    Carr, Norman J; Olmos, Martin; Bushnell, John

    2008-10-01

    Modern integrated medical curricula usually do not include a separate pathology course. Consequently, there is a risk that important pathological principles may be omitted. We aimed to ensure that pathology is properly represented by developing a core pathology curriculum created in consultation with local pathologists. Appropriate information technology to track the delivery of this material within the integrated curriculum structure was developed using a learning content management system in which a metadata schema was constructed. This allows a sophisticated view of where and how pathology appears in the course and can also increase the visibility of the subject by demonstrating the central place of pathology in medicine. In conclusion, a core curriculum in pathology that can be tracked by information technology with sufficient power and flexibility is a solution to the potential loss of pathology from integrated medical courses. We believe the result is superior to a stand-alone pathology course.

  20. Semantic integration of medication data into the EHOP Clinical Data Warehouse.

    Science.gov (United States)

    Delamarre, Denis; Bouzille, Guillaume; Dalleau, Kevin; Courtel, Denis; Cuggia, Marc

    2015-01-01

    Reusing medication data is crucial for many medical research domains. Semantic integration of such data in clinical data warehouse (CDW) is quite challenging. Our objective was to develop a reliable and scalable method for integrating prescription data into EHOP (a French CDW). PN13/PHAST was used as the semantic interoperability standard during the ETL process, and to store the prescriptions as documents in the CDW. Theriaque was used as a drug knowledge database (DKDB), to annotate the prescription dataset with the finest granularity, and to provide semantic capabilities to the EHOP query workbench. the system was evaluated on a clinical data set. Depending on the use case, the precision ranged from 52% to 100%, Recall was always 100%. interoperability standards and DKDB, document approach, and the finest granularity approach are the key factors for successful drug data integration in CDW.

  1. Toward a quantitative approach to migrants integration

    Science.gov (United States)

    Barra, A.; Contucci, P.

    2010-03-01

    Migration phenomena and all the related issues, like integration of different social groups, are intrinsically complex problems since they strongly depend on several competitive mechanisms as economic factors, cultural differences and many others. By identifying a few essential assumptions, and using the statistical mechanics of complex systems, we propose a novel quantitative approach that provides a minimal theory for those phenomena. We show that the competitive interactions in decision making between a population of N host citizens and P immigrants, a bi-partite spin-glass, give rise to a social consciousness inside the host community in the sense of the associative memory of neural networks. The theory leads to a natural quantitative definition of migrant's "integration" inside the community. From the technical point of view this minimal picture assumes, as control parameters, only general notions like the strength of the random interactions, the ratio between the sizes of the two parties and the cultural influence. Few steps forward, toward more refined models, which include a digression on the kind of the felt experiences and some structure on the random interaction topology (as dilution to avoid the plain mean-field approach) and correlations of experiences felt between the two parties (biasing the distribution of the coupling) are discussed at the end, where we show the robustness of our approach.

  2. Transforming Medical Education: Is Competency-Based Medical Education the Right Approach?

    Science.gov (United States)

    Whitcomb, Michael E

    2016-05-01

    There is growing recognition within the medical education community that medical education in this country needs to be changed to better prepare doctors for the challenges they will face in providing their patients high-quality medical care. A competency-based medical education (CBME) approach was endorsed by the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties approximately 15 years ago, and a self-designated group-the International Competency-Based Medical Education (ICBME) Collaborators-is now calling on members of the medical education community to join them in their effort to establish CBME as the approach to be used in transforming medical education, not only in the United States but also around the world.In response to an article in this issue by a group of ICBME Collaborators, the author argues that more evidence about the effectiveness of CBME is needed before a global shift to this approach is undertaken. It is time for major organizations and foundations that are committed to improving medical education to step forward and take the lead in partnering with the medical education community to conduct a critical evaluation of CBME. In addition, maintenance of certification, relicensure, and continuing medical education programs should be evaluated for their effectiveness in ensuring that physicians are clinically competent not only at the beginning of their career but also until the end.

  3. FUPOL: an Integrated Approach to Participative Policies

    Directory of Open Access Journals (Sweden)

    Silvana Tomic Rotim

    2014-05-01

    Full Text Available The Future Policy Modelling Project (FUPOL is a research project funded by the 7th framework program of the European Union. Its research focus are new technologies and methods for e-governance, e-participation and policy modelling. The FUPOL consortium consists of partners from European countries, China and Kenya. and comprises innovative multinational companies, leading research institutes, high-level political organizations as well as strong pilot partners. This paper describes the FUPOL new integrated approach to policy design and implementation including also specific examples from real life pilots in cities from different countries. FUPOL consists of an advanced policy lifecycle and an IT-solution with features supporting all phases of the proposed lifecycle. The FUPOL concept and functional modules as well as the technical architecture to achieve such a complete integration are described.

  4. Pedagogic process modeling: Humanistic-integrative approach

    Directory of Open Access Journals (Sweden)

    Boritko Nikolaj M.

    2007-01-01

    Full Text Available The paper deals with some current problems of modeling the dynamics of the subject-features development of the individual. The term "process" is considered in the context of the humanistic-integrative approach, in which the principles of self education are regarded as criteria for efficient pedagogic activity. Four basic characteristics of the pedagogic process are pointed out: intentionality reflects logicality and regularity of the development of the process; discreteness (stageability in dicates qualitative stages through which the pedagogic phenomenon passes; nonlinearity explains the crisis character of pedagogic processes and reveals inner factors of self-development; situationality requires a selection of pedagogic conditions in accordance with the inner factors, which would enable steering the pedagogic process. Offered are two steps for singling out a particular stage and the algorithm for developing an integrative model for it. The suggested conclusions might be of use for further theoretic research, analyses of educational practices and for realistic predicting of pedagogical phenomena. .

  5. Quantum gravitation the Feynman path integral approach

    CERN Document Server

    Hamber, Herbert W

    2009-01-01

    The book covers the theory of Quantum Gravitation from the point of view of Feynman path integrals. These provide a manifestly covariant approach in which fundamental quantum aspects of the theory such as radiative corrections and the renormalization group can be systematically and consistently addressed. The path integral method is suitable for both perturbative as well as non-perturbative studies, and is known to already provide a framework of choice for the theoretical investigation of non-abelian gauge theories, the basis for three of the four known fundamental forces in nature. The book thus provides a coherent outline of the present status of the theory gravity based on Feynman’s formulation, with an emphasis on quantitative results. Topics are organized in such a way that the correspondence to similar methods and results in modern gauge theories becomes apparent. Covariant perturbation theory are developed using the full machinery of Feynman rules, gauge fixing, background methods and ghosts. The ren...

  6. Introduction to solid mechanics an integrated approach

    CERN Document Server

    Lubliner, Jacob

    2014-01-01

    This textbook presents for the first time in one text the concepts and processes covered in statics and mechanics of materials curricula following a systematic, topically integrated approach. Since the turn of the millennium, it has become common in engineering schools to combine the traditional undergraduate offerings in rigid-body statics (usually called “statics”) and deformable body mechanics (known traditionally as “strength of materials” or, more recently, “mechanics of materials”) into a single, introductory course in solid mechanics. Many textbooks for the new course sequentially meld pieces of existing, discrete books—sometimes, but not always, acknowledging the origin—into two halves covering Statics and Mechanics of Materials. In this volume, Professors Lubliner and Papadopoulos methodically combine the essentials of statics and mechanics of materials, illustrating the relationship of concepts throughout, into one "integrated" text. This book also: ·         Offers thorough...

  7. Integration models: multicultural and liberal approaches confronted

    Science.gov (United States)

    Janicki, Wojciech

    2012-01-01

    European societies have been shaped by their Christian past, upsurge of international migration, democratic rule and liberal tradition rooted in religious tolerance. Boosting globalization processes impose new challenges on European societies, striving to protect their diversity. This struggle is especially clearly visible in case of minorities trying to resist melting into mainstream culture. European countries' legal systems and cultural policies respond to these efforts in many ways. Respecting identity politics-driven group rights seems to be the most common approach, resulting in creation of a multicultural society. However, the outcome of respecting group rights may be remarkably contradictory to both individual rights growing out from liberal tradition, and to reinforced concept of integration of immigrants into host societies. The hereby paper discusses identity politics upturn in the context of both individual rights and integration of European societies.

  8. MEDICAL BRAIN DRAIN - A THEORETICAL APPROACH

    Directory of Open Access Journals (Sweden)

    Boncea Irina

    2013-07-01

    Full Text Available Medical brain drain is defined as the migration of health personnel from developing countries to developed countries and between industrialized nations in search for better opportunities. This phenomenon became a global growing concern due to its impact on both the donor and the destination countries. This article aims to present the main theoretical contributions starting from 1950 until today and the historical evolution, in the attempt of correlating the particular case of medical brain drain with the theory and evolution of the brain drain in general. This article raises questions and offers answers, identifies the main issues and looks for possible solutions in order to reduce the emigration of medical doctors. Factors of influence include push (low level of income, poor working conditions, the absence of job openings and social recognition, oppressive political climate and pull (better remuneration and working conditions, prospects for career development, job satisfaction, security factors. Developing countries are confronting with the loss of their most valuable intellectuals and the investment in their education, at the benefit of developed nations. An ethical debate arises as the disparities between countries increases, industrialized nations filling in the gaps in health systems with professionals from countries already facing shortages. However, recent literature emphasizes the possibility of a “beneficial brain drain” through education incentives offered by the emigration prospects. Other sources of “brain gain” for donor country are the remittances, the scientific networks and return migration. Measures to stem the medical brain drain involve the common effort and collaboration between developing and developed countries and international organizations. Measures adopted by donor countries include higher salaries, better working conditions, security, career opportunities, incentives to stimulate return migration. Destination

  9. A MEDICAL APPROACH TO LANGUAGE DELAY

    African Journals Online (AJOL)

    Enrique

    Language prob- lems interfere with a child's ability to communicate effectively, both in the expres- ... embodied in different specialists, making a team approach appropriate. Doctors need to ..... Management of expressive ... A modified teaching.

  10. The Integrated Medical Model: A Probabilistic Simulation Model Predicting In-Flight Medical Risks

    Science.gov (United States)

    Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G., Jr.

    2015-01-01

    The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting

  11. The Integrated Medical Model: A Probabilistic Simulation Model for Predicting In-Flight Medical Risks

    Science.gov (United States)

    Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G.

    2015-01-01

    The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting

  12. A Semantic Medical Multimedia Retrieval Approach Using Ontology Information Hiding

    OpenAIRE

    2013-01-01

    Searching useful information from unstructured medical multimedia data has been a difficult problem in information retrieval. This paper reports an effective semantic medical multimedia retrieval approach which can reflect the users’ query intent. Firstly, semantic annotations will be given to the multimedia documents in the medical multimedia database. Secondly, the ontology that represented semantic information will be hidden in the head of the multimedia documents. The main innovations of ...

  13. Integrated design approach for controlled mechanical structures

    Energy Technology Data Exchange (ETDEWEB)

    Kiriazov, P. [Bulgarian Academy of Sciences, Sofia (Bulgaria). Inst. of Mechanics

    1998-10-01

    This study is addressed to design problems of controlled mechanical structures (CMS) like robot manipulators and engineering systems with active vibration control that may be subject to arbitrary disturbances. Along with the basic design requirement for strength/load capacity, additional design criteria for CMS are needed to meet the continuously increasing demands for faster response, improved precision and reduced energy consumption. As a CMS is a functionally directed assembly of mutually influencing components: control, actuator, mechanical, and sensor subsystems, a conceptual framework for their integrated design is required. Parameters of these subsystems influencing the dynamic performance of CMS define a matrix that transfers the control inputs into the controlled outputs (accelerations). This transfer matrix plays the key role in the integrated structure-control design. We consider the design optimization problem for CMS having decentralized control architecture. An integrated design criterion for such systems is proposed which is based on optimal trade-off relations between bounds of model uncertainties and control force limits. Optimizing this criterion leads to CMS with maximum degree of robustness. The approach proposed makes it possible a decomposition of the overall design problem into design problems for the CMS`s components. The design concepts are applied to the mechanical subsystem of planar linkage systems. Robust decentralized controllers are designed for a two-degree-of-freedom manipulator with elastic joints. (orig.)

  14. Approach for Improving the Integrated Sensor Orientation

    Science.gov (United States)

    Mitishita, E.; Ercolin Filho, L.; Graça, N.; Centeno, J.

    2016-06-01

    The direct determination of exterior orientation parameters (EOP) of aerial images via integration of the Inertial Measurement Unit (IMU) and GPS is often used in photogrammetric mapping nowadays. The accuracies of the EOP depend on the accurate parameters related to sensors mounting when the job is performed (offsets of the IMU relative to the projection centre and the angles of boresigth misalignment between the IMU and the photogrammetric coordinate system). In principle, when the EOP values do not achieve the required accuracies for the photogrammetric application, the approach, known as Integrated Sensor Orientation (ISO), is used to refine the direct EOP. ISO approach requires accurate Interior Orientation Parameters (IOP) and standard deviation of the EOP under flight condition. This paper investigates the feasibility of use the in situ camera calibration to obtain these requirements. The camera calibration uses a small sub block of images, extracted from the entire block. A digital Vexcel UltraCam XP camera connected to APPLANIX POS AVTM system was used to get two small blocks of images that were use in this study. The blocks have different flight heights and opposite flight directions. The proposed methodology improved significantly the vertical and horizontal accuracies of the 3D point intersection. Using a minimum set of control points, the horizontal and vertical accuracies achieved nearly one image pixel of resolution on the ground (GSD). The experimental results are shown and discussed.

  15. APPROACH FOR IMPROVING THE INTEGRATED SENSOR ORIENTATION

    Directory of Open Access Journals (Sweden)

    E. Mitishita

    2016-06-01

    Full Text Available The direct determination of exterior orientation parameters (EOP of aerial images via integration of the Inertial Measurement Unit (IMU and GPS is often used in photogrammetric mapping nowadays. The accuracies of the EOP depend on the accurate parameters related to sensors mounting when the job is performed (offsets of the IMU relative to the projection centre and the angles of boresigth misalignment between the IMU and the photogrammetric coordinate system. In principle, when the EOP values do not achieve the required accuracies for the photogrammetric application, the approach, known as Integrated Sensor Orientation (ISO, is used to refine the direct EOP. ISO approach requires accurate Interior Orientation Parameters (IOP and standard deviation of the EOP under flight condition. This paper investigates the feasibility of use the in situ camera calibration to obtain these requirements. The camera calibration uses a small sub block of images, extracted from the entire block. A digital Vexcel UltraCam XP camera connected to APPLANIX POS AVTM system was used to get two small blocks of images that were use in this study. The blocks have different flight heights and opposite flight directions. The proposed methodology improved significantly the vertical and horizontal accuracies of the 3D point intersection. Using a minimum set of control points, the horizontal and vertical accuracies achieved nearly one image pixel of resolution on the ground (GSD. The experimental results are shown and discussed.

  16. A critical approach to the development of blended medical ...

    African Journals Online (AJOL)

    vocational training course in Afrikaans as a second language was ... developed into an online/mobile tool for medical communication in six European languages (Danish, Dutch, ... medical orientation is patient-centred, an approach common in the West, and thus ... framework and an illness framework (Levenstein et al.

  17. National electronic medical records integration on cloud computing system.

    Science.gov (United States)

    Mirza, Hebah; El-Masri, Samir

    2013-01-01

    Few Healthcare providers have an advanced level of Electronic Medical Record (EMR) adoption. Others have a low level and most have no EMR at all. Cloud computing technology is a new emerging technology that has been used in other industry and showed a great success. Despite the great features of Cloud computing, they haven't been utilized fairly yet in healthcare industry. This study presents an innovative Healthcare Cloud Computing system for Integrating Electronic Health Record (EHR). The proposed Cloud system applies the Cloud Computing technology on EHR system, to present a comprehensive EHR integrated environment.

  18. Information integrity and privacy for computerized medical patient records

    Energy Technology Data Exchange (ETDEWEB)

    Gallegos, J.; Hamilton, V.; Gaylor, T.; McCurley, K.; Meeks, T.

    1996-09-01

    Sandia National Laboratories and Oceania, Inc. entered into a Cooperative Research and Development Agreement (CRADA) in November 1993 to provide ``Information Integrity and Privacy for Computerized Medical Patient Records`` (CRADA No. SC93/01183). The main objective of the project was to develop information protection methods that are appropriate for databases of patient records in health information systems. This document describes the findings and alternative solutions that resulted from this CRADA.

  19. [Service Middleware of Medical Information Integration and Exchange Based on HL7 and DICOM].

    Science.gov (United States)

    Huang, Mian; Liu, Lijun; Xiong, Xin; Fan, Hongbo; Jia, Lianyin; Tang, Shouguo

    2015-08-01

    Medical information exchange and integration is the effective method to solve the interoperability and medical information island, and is the basis of medical information sharing. In this paper, we take medical texts and medical images as the basic integrated objects, DICOM, HL7 messages and datasets as the integrated units, efficient DI-COM, HL7 message construction and parsing methods as basis, design and realize a universal medical information integration and exchange service middleware. Experimental results show that the prototype system could perform medical information integration and exchange among relational database, HL7 and DICOM message, provide a feasible scheme to solve the medical information island and lay a good foundation for establishing the unified medical information integration and sharing platform. The middleware has been applied in the project named "development and demonstration of opened medical information integration system".

  20. Medical device integration: CIOs must bridge the digital divide between devices and electronic medical records.

    Science.gov (United States)

    Raths, David

    2009-02-01

    To get funding approved for medical device integration, ClOs suggest focusing on specific patient safety or staff efficiency pain points. Organizations that make clinical engineering part of their IT team report fewer chain-of-command issues. It also helps IT people understand the clinical goals because the engineering people have been working closely with clinicians for years. A new organization has formed to work on collaboration between clinical engineers and IT professionals. For more information, go to www.ceitcollaboration.org. ECRI Institute has written a guide to handling the convergence of medical technology and hospital networks. Its "Medical Technology for the IT Professional: An Essential Guide for Working in Today's Healthcare Setting" also details how IT professionals can assist hospital technology planning and acquisition, and provide ongoing support for IT-based medical technologies. For more information, visit www.ecri.org/ITresource.

  1. Integrating systems Approaches into Pharmaceutical Sciences

    DEFF Research Database (Denmark)

    Westerhoff, H.V.; Mosekilde, Erik; Noe, C. R.

    2008-01-01

    of the conference was to promote the ‘Integration of Systems Approaches into Pharmaceutical Sciences’ in view of optimising the development of new effective drugs. And a challenge this is, considering both the high attrition rates in the pharmaceutical industry and the failure of finding definitive drug solutions......During the first week of December 2007, the European Federation for Pharmaceutical Sciences (EUFEPS) and BioSim, the major European Network of Excellence on Systems Biology, held a challenging conference on the use of mathematical models in the drug development process. More precisely, the purpose...... for many of the diseases that plague mankind today. The conference was co-sponsored by the American College of Clinical Pharmacology, the European Center for Pharmaceutical Medicine, and the Swiss Society of Pharmaceutical Sciences and, besides representatives from the European Regulatory Agencies and FDA...

  2. Stakeholder interaction within the ERICA Integrated Approach

    Energy Technology Data Exchange (ETDEWEB)

    Zinger, I. [Swedish Radiation Protection Authority, 171 16 Stockholm (Sweden)], E-mail: irene@facilia.se; Oughton, D.H. [Norwegian University of Life Sciences, Department of Plant and Environmental Sciences, PO Box 5003, 1432 As (Norway); Jones, S.R. [Westlakes Scientific Consulting Ltd., Westlakes Research Institute/Westlakes Scientific Consulting, Westlakes Science Park Moor Row, Cumbria CA24 3LN (United Kingdom)

    2008-09-15

    Within the ERICA project, stakeholder involvement has been addressed within three main areas: generic interactions throughout the project, specific consultation by means of attendance to events and considerations as part of the ERICA Integrated Approach and Assessment Tool. The word stakeholders meant namely any individual or group who may be affected by or have an interest in an issue, and to include experts, lay-people and the public. An End-Users-Group (EUG) was set up to facilitate the two-way dialogue between the ERICA Consortium and stakeholders. The ERICA EUG consisted of representatives of 60 organisations ranging from regulatory bodies, national advisory bodies, academia, non-governmental organisations, industry, consultants and inter-governmental organisations. Stakeholder interaction was included from the very start of the project. Inputs from the EUG were recorded and in most instances incorporated within the development of the project and thus influenced and helped to shape some of the ERICA deliverables.

  3. Permutation statistical methods an integrated approach

    CERN Document Server

    Berry, Kenneth J; Johnston, Janis E

    2016-01-01

    This research monograph provides a synthesis of a number of statistical tests and measures, which, at first consideration, appear disjoint and unrelated. Numerous comparisons of permutation and classical statistical methods are presented, and the two methods are compared via probability values and, where appropriate, measures of effect size. Permutation statistical methods, compared to classical statistical methods, do not rely on theoretical distributions, avoid the usual assumptions of normality and homogeneity of variance, and depend only on the data at hand. This text takes a unique approach to explaining statistics by integrating a large variety of statistical methods, and establishing the rigor of a topic that to many may seem to be a nascent field in statistics. This topic is new in that it took modern computing power to make permutation methods available to people working in the mainstream of research. This research monograph addresses a statistically-informed audience, and can also easily serve as a ...

  4. Evaluating Pain Education Programs: An Integrated Approach

    Directory of Open Access Journals (Sweden)

    Adam Dubrowski

    2011-01-01

    Full Text Available Evaluation of educational programs and assessment of learning are essential to maintain high-standard health science education, which includes pain education. Current models of program evaluations applied to the education of the health professions, such as the Kirkpatrick model, are mainly outcome based. More recently, efforts have been made to examine other process-based models such as the Context Input Process Product model. The present article proposes an approach that integrates both outcome- and process-based models with models of clinical performance assessment to provide a deeper understanding of a program function. Because assessment instruments are a critical part of program evaluation, it is suggested that standardization and rigour should be used in their selection, development and adaptation. The present article suggests an alternative to currently used models in pain education evaluation.

  5. Thermodynamics and statistical mechanics an integrated approach

    CERN Document Server

    Shell, M Scott

    2015-01-01

    Learn classical thermodynamics alongside statistical mechanics with this fresh approach to the subjects. Molecular and macroscopic principles are explained in an integrated, side-by-side manner to give students a deep, intuitive understanding of thermodynamics and equip them to tackle future research topics that focus on the nanoscale. Entropy is introduced from the get-go, providing a clear explanation of how the classical laws connect to the molecular principles, and closing the gap between the atomic world and thermodynamics. Notation is streamlined throughout, with a focus on general concepts and simple models, for building basic physical intuition and gaining confidence in problem analysis and model development. Well over 400 guided end-of-chapter problems are included, addressing conceptual, fundamental, and applied skill sets. Numerous worked examples are also provided together with handy shaded boxes to emphasize key concepts, making this the complete teaching package for students in chemical engineer...

  6. Structure determines medication errors in nursing units: a mechanistic approach.

    Science.gov (United States)

    Hung, Chang-Chiao; Lee, Bih-O; Tsai, Shu-Ling; Tseng, Yun Shan; Chang, Chia-Hao

    2015-03-01

    Medication errors have long been considered critical in global health care systems. However, few studies have been conducted to explore the effects of nursing unit structure on medication errors. The purpose of this study, therefore, was to determine the effects of structural factors on medication errors in nursing units. A total of 977 staff nurses and 62 head nurses participated in this cross-sectional design study. The findings show that professional autonomy (β = .53, t = 6.03, p nursing experts (β = .52, t = 5.99, p medication error rates. This study shows that the structural factors influence medication administration and the mechanistic approach is specifically in relation of low medication error rates. The author suggests that head nurses should consider strategies that require adjustments to unit control mechanisms.

  7. Systematic Approach to Better Understanding Integration Costs

    Energy Technology Data Exchange (ETDEWEB)

    Stark, Gregory B. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-09-01

    This research presents a systematic approach to evaluating the costs of integrating new generation and operational procedures into an existing power system, and the methodology is independent of the type of change or nature of the generation. The work was commissioned by the U.S. Department of Energy and performed by the National Renewable Energy Laboratory to investigate three integration cost-related questions: (1) How does the addition of new generation affect a system's operational costs, (2) How do generation mix and operating parameters and procedures affect costs, and (3) How does the amount of variable generation (non-dispatchable wind and solar) impact the accuracy of natural gas orders? A detailed operational analysis was performed for seven sets of experiments: variable generation, large conventional generation, generation mix, gas prices, fast-start generation, self-scheduling, and gas supply constraints. For each experiment, four components of integration costs were examined: cycling costs, non-cycling VO&M costs, fuel costs, and reserves provisioning costs. The investigation was conducted with PLEXOS production cost modeling software utilizing an updated version of the Institute of Electrical and Electronics Engineers 118-bus test system overlaid with projected operating loads from the Western Electricity Coordinating Council for the Sacramento Municipal Utility District, Puget Sound Energy, and Public Service Colorado in the year 2020. The test system was selected in consultation with an industry-based technical review committee to be a reasonable approximation of an interconnection yet small enough to allow the research team to investigate a large number of scenarios and sensitivity combinations. The research should prove useful to market designers, regulators, utilities, and others who want to better understand how system changes can affect production costs.

  8. Extended device profiles and testing procedures for the approval process of integrated medical devices using the IEEE 11073 communication standard.

    Science.gov (United States)

    Janß, Armin; Thorn, Johannes; Schmitz, Malte; Mildner, Alexander; Dell'Anna-Pudlik, Jasmin; Leucker, Martin; Radermacher, Klaus

    2017-08-25

    Nowadays, only closed and proprietary integrated operating room systems (IORS) from big manufacturers are available on the market. Hence, the interconnection of components from third-party vendors is only possible with increased time and costs. In the context of the German Federal Ministry of Education and Research (BMBF)-funded project OR.NET (2012-2016), the open integration of medical devices from different manufacturers was addressed. An integrated operating theater based on the open communication standard IEEE 11073 shall give clinical operators the opportunity to choose medical devices independently of the manufacturer. This approach would be advantageous especially for hospital operators and small- and medium-sized enterprises (SME) of medical devices. Actual standards and concepts regarding technical feasibility and the approval process do not cope with the requirements for a modular integration of medical devices in the operating room (OR), based on an open communication standard. Therefore, innovative approval strategies and corresponding certification and test procedures, which cover actual legal and normative standards, have to be developed in order to support the future risk management and the usability engineering process of open integrated medical devices in the OR. The use of standardized device and service profiles and a three-step testing procedure, including conformity, interoperability and integration tests are described in this paper and shall support the manufacturers to integrate their medical devices without disclosing the medical devices' risk analysis and related confidential expertise or proprietary information.

  9. Integrative Medical Care Plus Mindfulness Training for Patients With Congestive Heart Failure: Proof of Concept.

    Science.gov (United States)

    Kemper, Kathi J; Carmin, Cheryl; Mehta, Bella; Binkley, Phillip

    2016-10-01

    Congestive heart failure (CHF) has a high rate of morbidity and mortality. It is often accompanied by other medical and psychosocial comorbidities that complicate treatment and adherence. We conducted a proof of concept pilot project to determine the feasibility of providing integrative group medical visits plus mindfulness training for patients recently discharged with CHF. Patients were eligible if they had been discharged from an inpatient stay for CHF within the 12 months prior to the new program. The Compassionate Approach to Lifestyle and Mind-Body (CALM) Skills for Patients with CHF consisted of 8 weekly visits focusing on patient education about medications, diet, exercise, sleep, and stress management; group support; and training in mind-body skills such as mindfulness, self-compassion, and loving-kindness. Over two 8-week sessions, 8/11 (73%) patients completed at least 4 visits. The patients had an average age of 57 years. The most common comorbidities were weight gain, sleep problems, and fatigue. After the sessions, 100% of patients planned to make changes to their diet, exercise, and stress management practices. Over half of the patients who met with a pharmacist had a medication-related problem. Improvements were observed in depression, fatigue, and satisfaction with life. Integrative group visits focusing on healthy lifestyle, support, and skill-building are feasible even among CHF patients and should be evaluated in controlled trials as a patient-centered approach to improving outcomes related to improving medication management, depression, fatigue, and quality of life.

  10. Age Classification Based On Integrated Approach

    Directory of Open Access Journals (Sweden)

    Pullela. SVVSR Kumar

    2014-05-01

    Full Text Available The present paper presents a new age classification method by integrating the features derived from Grey Level Co-occurrence Matrix (GLCM with a new structural approach derived from four distinct LBP's (4-DLBP on a 3 x 3 image. The present paper derived four distinct patterns called Left Diagonal (LD, Right diagonal (RD, vertical centre (VC and horizontal centre (HC LBP's. For all the LBP's the central pixel value of the 3 x 3 neighbourhood is significant. That is the reason in the present research LBP values are evaluated by comparing all 9 pixels of the 3 x 3 neighbourhood with the average value of the neighbourhood. The four distinct LBP's are grouped into two distinct LBP's. Based on these two distinct LBP's GLCM is computed and features are evaluated to classify the human age into four age groups i.e: Child (0-15, Young adult (16-30, Middle aged adult (31-50 and senior adult (>50. The co-occurrence features extracted from the 4-DLBP provides complete texture information about an image which is useful for classification. The proposed 4-DLBP reduces the size of the LBP from 6561 to 79 in the case of original texture spectrum and 2020 to 79 in the case of Fuzzy Texture approach.

  11. Pressure Shell Approach to Integrated Environmental Protection

    Science.gov (United States)

    Kennedy, Kriss J.

    2011-01-01

    The next generation of exploration mission human systems will require environmental protection such as radiation protection that is effective and efficient. In order to continue human exploration, habitat systems will require special shells to protect astronauts from hostile environments. The Pressure Shell Approach to integrated environmental (radiation) protection is a multi-layer shell that can be used for multifunctional environmental protection. Self-healing, self-repairing nano technologies and sensors are incorporated into the shell. This shell consists of multiple layers that can be tailored for specific environmental protection needs. Mainly, this innovation focuses on protecting crew from exposure to micrometeorites, thermal, solar flares, and galactic cosmic ray (GCR) radiation. The Pressure Shell Approach consists of a micrometeoroid and secondary ejecta protection layer; a thin, composite shell placed in between two layers that is non-structural; an open cavity layer that can be filled with water, regolith, or polyethylene foam; a thicker composite shell that is a structural load bearing that is placed between two layers; and a bladder coating on the interior composite shell. This multi-layer shell creates an effective radiation protection system. Most of its layers can be designed with the materials necessary for specific environments. In situ materials such as water or regolith can be added to the shell design for supplemental radiation protection.

  12. Review and expectation of integrated curriculum of basic medical sciences of Shanghai Jiao Tong University

    Institute of Scientific and Technical Information of China (English)

    Xiao-yin NIU; Song YU; Xiao-kui GUO

    2015-01-01

    Since early 1950 s,many domestic and foreign medical schools have carried out the integrated teaching reform of medical education. In our school of basic medical sciences,there have been three types of integrated curriculum reform carried out in history,i. e. horizontally integrated courses,problem-oriented basic medical sciences curriculum, and organ system-based integrated curriculum. This article reviews the experience of these three teaching reforms and the problems encountered and hopes to provide some references for the integration of basic medical sciences curriculum of other medical schools.

  13. A Strategic Approach to Medical Care for Exploration Missions

    Science.gov (United States)

    Canga, Michael A.; Shah, Ronak V.; Mindock, Jennifer A.; Antonsen, Erik L.

    2016-01-01

    Exploration missions will present significant new challenges to crew health, including effects of variable gravity environments, limited communication with Earth-based personnel for diagnosis and consultation for medical events, limited resupply, and limited ability for crew return. Providing health care capabilities for exploration class missions will require system trades be performed to identify a minimum set of requirements and crosscutting capabilities, which can be used in design of exploration medical systems. Medical data, information, and knowledge collected during current space missions must be catalogued and put in formats that facilitate querying and analysis. These data are used to inform the medical research and development program through analysis of risk trade studies between medical care capabilities and system constraints such as mass, power, volume, and training. Medical capability as a quantifiable variable is proposed as a surrogate risk metric and explored for trade space analysis that can improve communication between the medical and engineering approaches to mission design. The resulting medical system design approach selected will inform NASA mission architecture, vehicle, and subsystem design for the next generation of spacecraft.

  14. An Integrated Approach to Crop Genetic Improvement

    Institute of Scientific and Technical Information of China (English)

    Martin A. J. Parry; Malcolm J. Hawkesford

    2012-01-01

    The balance between the supply and demand of the major food crops is fragile,fueling concerns for long-term global food security.The rising population,increasing wealth and a proliferation of nonfood uses (e.g.bioenergy) has led to growing demands on agriculture,while increased production is limited by greater urbanization,and the degradation of land.Furthermore,global climate change with increasing temperatures and lower,more erratic rainfall is projected to decrease agricultural yields.There is a predicted need to increase food production by at least 70% by 2050 and therefore an urgent need to develop novel and integrated approaches,incorporating high-throughput phenotyping that will both increase production per unit area and simultaneously improve the resource use efficiency of crops.Yield potential,yield stability,nutrient and water use are all complex multigenic traits and while there is genetic variability,their complexity makes such traits difficult to breed for directly.Nevertheless molecular plant breeding has the potential to deliver substantial improvements,once the component traits and the genes underlying these traits have been identified.In addition,interactions between the individual traits must also be taken into account,a demand that is difficult to fulfill with traditional screening approaches.Identified traits will be incorporated into new cultivars using conventional or biotechnological tools.In order to better understand the relationship between genotype,component traits,and environment over time,a multidisciplinary approach must be adopted to both understand the underlying processes and identify candidate genes,QTLs and traits that can be used to develop improved crops.

  15. A knowledge integration approach to flood vulnerability

    Science.gov (United States)

    Mazzorana, Bruno; Fuchs, Sven

    2014-05-01

    Understanding, qualifying and quantifying vulnerability is an essential need for implementing effective and efficient flood risk mitigation strategies; in particular if possible synergies between different mitigation alternatives, such as active and passive measures, should be achieved. In order to combine different risk management options it is necessary to take an interdisciplinary approach to vulnerability reduction, and as a result the affected society may be willing to accept a certain degree of self-responsibility. However, due to differing mono-disciplinary approaches and regional foci undertaken until now, different aspects of vulnerability to natural hazards in general and to floods in particular remain uncovered and as a result the developed management options remain sub-optimal. Taking an even more fundamental viewpoint, the empirical vulnerability functions used in risk assessment specifically fail to capture physical principles of the damage-generating mechanisms to the build environment. The aim of this paper is to partially close this gap by discussing a balanced knowledge integration approach which can be used to resolve the multidisciplinary disorder in flood vulnerability research. Modelling techniques such as mathematical-physical modelling of the flood hazard impact to and response from the building envelope affected, and formative scenario analyses of possible consequences in terms of damage and loss are used in synergy to provide an enhanced understanding of vulnerability and to render the derived knowledge into interdisciplinary mitigation strategies. The outlined formal procedure allows for a convincing knowledge alignment of quantified, but partial, information about vulnerability as a result of the application of physical and engineering notions and valuable, but often underspecified, qualitative argumentation strings emerging from the adopted socio-economic viewpoint.

  16. Integrating social factors into cross-cultural medical education.

    Science.gov (United States)

    Green, Alexander R; Betancourt, Joseph R; Carrillo, J Emilio

    2002-03-01

    The field of cross-cultural medical education has blossomed in an environment of increasing diversity and increasing awareness of the effect of race and ethnicity on health outcomes. However, there is still no standardized approach to teaching doctors in training how best to care for diverse patient populations. As standards are developed, it is crucial to realize that medical educators cannot teach about culture in a vacuum. Caring for patients of diverse cultural backgrounds is inextricably linked to caring for patients of diverse social backgrounds. In this article, the authors discuss the importance of social issues in caring for patients of all cultures, and propose a practical, patient-based approach to social analysis covering four major domains--(1) social stress and support networks, (2) change in environment, (3) life control, and (4) literacy. By emphasizing and expanding the role of the social history in cross-cultural medical education, faculty can better train medical students, residents, and other health care providers to care for socioculturally diverse patient populations.

  17. Librarian integration in a four-year medical school curriculum: a timeline.

    Science.gov (United States)

    MacEachern, Mark; Townsend, Whitney; Young, Kristen; Rana, Gurpreet

    2012-01-01

    The Taubman Health Sciences Library (THL) is integrated in all four years of the University of Michigan Medical School (UMMS) curriculum. Information resources are introduced at strategic points throughout the curriculum so that students receive training at times when they are most likely to need the resource. Most of the core instruction sessions are taught in teams that consist of librarians and UMMS faculty, which provides unique learning opportunities for students. This article describes each THL instruction activity in the four-year undergraduate UMMS curriculum and provides commentary on the overall effectiveness of this integrated approach to instruction.

  18. Development of Medical Insurance in Ukraine: System Approach

    Directory of Open Access Journals (Sweden)

    Svechkina Alina L.

    2014-01-01

    Full Text Available The goal of the article lies in building up a scientifically justified system of medical insurance for formation of efficient socio-economic protection of population in Ukraine. Having considered the system of medical insurance as a complex system, the article identifies its main characteristics, namely: integrity, hierarchy, structure, purposefulness, controllability, dynamics and openness. In the result of the study the article allocates the structure of the system of medical insurance, which contains four subsystems: formation, distribution, use of financial resources and control. The article justifies a necessity of development of the system with the aim of realisation of such principles of its functioning as prospectiveness, priority, realisation and step-by-step. Prospects of further studies in this direction are identification of the degree of attraction of private and state financial resources for healthcare, organisation of mandatory medical insurance, further development of voluntary medical insurance and health insurance funds with consideration of specific features of functioning of the national economy of Ukraine. Further development of the system of medical insurance would facilitate introduction of the state and private subsystems of financial provision, increase of efficiency of management in combination with development of the medical science and would ensure gradual changes in the healthcare system, which would have a positive influence upon improvement of health of the population and increase of socio-economic efficiency of the medical industry of Ukraine.

  19. Integrated approach to optomechanical system development

    Science.gov (United States)

    Reney, Thomas E.; Wiggins, Richard L.; Comstock, Lovell E.; Santman, Jeffry J.; Woodard, Kenneth S.

    2011-06-01

    Over the past few decades of computer aided engineering growth there has been much more progress in increasing the power and capability of function specific engineering tools (e.g., optical design, finite element analysis, etc.) than in the integration of and communication between these tools. With only a few notable exceptions, such as FEA being imbedded into solid modeling, the communication method between the function specific tools continues to be dominated by translation to neutral data formats (e.g., IGES, STEP) and file transfer. There are a number of problems with this approach. The translation is a serial process where an engineer has to stop at some point in the design, make the neutral file, send that file to the next function, and wait for feedback. The translation through a neutral format is typically one way so the whole translation process has to be repeated when changes are required. Revision tracking of multiple files for each design iteration is both critical and a likely source of errors. Also, as with any translation, some information is always lost or corrupted in the process. This paper describes some progress that has been made in more tightly integrating optical design, mechanical design, fabrication, and testing of optical systems. Tools have been developed that connect CODE V®[1] to SolidWorks®[2] (bidirectional), compensation of diamond turning CNC from interferometric data, slope analysis from interferometer and profilometer data, and other tools for wavefront error compensation, and electronic nulls. Design, machining, testing and inspection efficiency gains are achieved through tools that consume mechanical solid models in their native format.

  20. Current and future perspectives on integrative traditional Chinese and Western medical management of gastroenterological diseases

    Directory of Open Access Journals (Sweden)

    WEI Beihai

    2013-04-01

    Full Text Available In recent years, significant progress has been made in the systematic investigation and application of integrative traditional Chinese and western medical management of digestive system diseases. Evidence-based modern investigations of the pathogenic processes and related etiologies are confirming the systemic nature of disease and the need for a comprehensive approach to clinical management. For example, the conditions of acute pancreatitis and hepatitis caused by pathogenic agents are intimately associated with inflammation signaling and circulatory function. In traditional Chinese medicine (TCM, the individual’s systemic condition is addressed, complementing the targeted approach of Western medicines and therapies. Here, we review the theoretical and biological aspects of the integrative treatment modality for the various pancreatic and hepatobilliarly diseases that have been reported. In particular, the outcomes and mechanisms of integrative management of chronic hepatitis, liver fibrosis and cirrhosis, severe acute pancreatitis, gallstones, and malignancies of the digestive system are discussed in the context of specific TCM herbs and decoctions.

  1. The Application of Corpus-based Teaching Approach to Medical English Vocabulary

    Institute of Scientific and Technical Information of China (English)

    张瑞君; 王连柱; 王兰英

    2009-01-01

    Insufficient vocabulary has become a barrier to reading comprehension and translation in the process of ME (medical English) study to the third-year students at medical universities or colleges.The current study was designed to investigate corpus- based teaching ap-proach to enlarging students'vocabulary in the course of higher learning of ML (medical literature).The study was carried out from 2006.9 to 2008.9 among third -year medical students in our college.Students were encouraged to augment their vocabulary by active practice,intensive learning,and comprehensive learning respectively through discovering study by using self-made ME corpuses (90,000 words).In doing so, their vocabulary was enlarged by actively using the essential vocabulary,attaching more attention to the difficult technical vocabulary,and getting familiar with medical terms,which eliminated their language barrier,improved their integrated language proficiency,and developed their sense of achievement.

  2. Artificial intelligence in medical diagnosis: the INTERNIST/CADUCEUS approach.

    Science.gov (United States)

    Banks, G

    1986-01-01

    The development of computers has provided a potential tool to assist in the management of the information explosion in medicine. The field of medical diagnosis is intellectually challenging and has attracted the attention of computer scientists interested in building expert systems using artificial intelligence techniques. This paper reviews some of the problems of medical diagnosis and discusses examples of programs representing different approaches to solving these problems. The programs developed in our laboratory, INTERNIST-1/CADUCEUS, are discussed in some detail.

  3. Integrating the results of user research into medical device development: insights from a case study

    Directory of Open Access Journals (Sweden)

    Martin Jennifer L

    2012-07-01

    Full Text Available Abstract Background It is well established that considering users is an important aspect of medical device development. However it is also well established that there are numerous barriers to successfully conducting user research and integrating the results into product development. It is not sufficient to simply conduct user research, it must also be effectively integrated into product development. Methods A case study of the development of a new medical imaging device was conducted to examine in detail how users were involved in a medical device development project. Two user research studies were conducted: a requirements elicitation interview study and an early prototype evaluation using contextual inquiry. A descriptive in situ approach was taken to investigate how these studies contributed to the product development process and how the results of this work influenced the development of the technology. Data was collected qualitatively through interviews with the development team, participant observation at development meetings and document analysis. The focus was on investigating the barriers that exist to prevent user data from being integrated into product development. Results A number of individual, organisational and system barriers were identified that functioned to prevent the results of the user research being fully integrated into development. The user and technological aspects of development were seen as separate work streams during development. The expectations of the developers were that user research would collect requirements for the appearance of the device, rather than challenge its fundamental concept. The manner that the user data was communicated to the development team was not effective in conveying the significance or breadth of the findings. Conclusion There are a range of informal and formal organisational processes that can affect the uptake of user data during medical device development. Adopting formal decision

  4. Integrating the results of user research into medical device development: insights from a case study.

    Science.gov (United States)

    Martin, Jennifer L; Barnett, Julie

    2012-07-19

    It is well established that considering users is an important aspect of medical device development. However it is also well established that there are numerous barriers to successfully conducting user research and integrating the results into product development. It is not sufficient to simply conduct user research, it must also be effectively integrated into product development. A case study of the development of a new medical imaging device was conducted to examine in detail how users were involved in a medical device development project. Two user research studies were conducted: a requirements elicitation interview study and an early prototype evaluation using contextual inquiry. A descriptive in situ approach was taken to investigate how these studies contributed to the product development process and how the results of this work influenced the development of the technology. Data was collected qualitatively through interviews with the development team, participant observation at development meetings and document analysis. The focus was on investigating the barriers that exist to prevent user data from being integrated into product development. A number of individual, organisational and system barriers were identified that functioned to prevent the results of the user research being fully integrated into development. The user and technological aspects of development were seen as separate work streams during development. The expectations of the developers were that user research would collect requirements for the appearance of the device, rather than challenge its fundamental concept. The manner that the user data was communicated to the development team was not effective in conveying the significance or breadth of the findings. There are a range of informal and formal organisational processes that can affect the uptake of user data during medical device development. Adopting formal decision making processes may assist manufacturers to take a more integrated and

  5. Current Status of Integral Medical Study on Endometriosis

    Institute of Scientific and Technical Information of China (English)

    YU Chao-qin (俞超芹); YU Jin (俞瑾)

    2003-01-01

    @@ Endometriosis (EM), an estrogen dependent disease that comes from the planting of endometrial gland and stroma outside the uterine cavity, is characterized by invasiveness, wide planting and liability to relapse. It has been proved by recent studies that the pathogenesis of EM has its genetic background and is closely related with neuro-, endocrino- and immuno-factors. There has been great progress in the treatment of EM, but the clinical effect is not yet satisfactory. Traditional Chinese medicine (TCM) has definitely played its role in EM treatment. In this article, the current status of integral medical study on EM is reviewed.

  6. Sleep Disruption Medical Intervention Forecasting (SDMIF) Module for the Integrated Medical Model

    Science.gov (United States)

    Lewandowski, Beth; Brooker, John; Mallis, Melissa; Hursh, Steve; Caldwell, Lynn; Myers, Jerry

    2011-01-01

    The NASA Integrated Medical Model (IMM) assesses the risk, including likelihood and impact of occurrence, of all credible in-flight medical conditions. Fatigue due to sleep disruption is a condition that could lead to operational errors, potentially resulting in loss of mission or crew. Pharmacological consumables are mitigation strategies used to manage the risks associated with sleep deficits. The likelihood of medical intervention due to sleep disruption was estimated with a well validated sleep model and a Monte Carlo computer simulation in an effort to optimize the quantity of consumables. METHODS: The key components of the model are the mission parameter program, the calculation of sleep intensity and the diagnosis and decision module. The mission parameter program was used to create simulated daily sleep/wake schedules for an ISS increment. The hypothetical schedules included critical events such as dockings and extravehicular activities and included actual sleep time and sleep quality. The schedules were used as inputs to the Sleep, Activity, Fatigue and Task Effectiveness (SAFTE) Model (IBR Inc., Baltimore MD), which calculated sleep intensity. Sleep data from an ISS study was used to relate calculated sleep intensity to the probability of sleep medication use, using a generalized linear model for binomial regression. A human yes/no decision process using a binomial random number was also factored into sleep medication use probability. RESULTS: These probability calculations were repeated 5000 times resulting in an estimate of the most likely amount of sleep aids used during an ISS mission and a 95% confidence interval. CONCLUSIONS: These results were transferred to the parent IMM for further weighting and integration with other medical conditions, to help inform operational decisions. This model is a potential planning tool for ensuring adequate sleep during sleep disrupted periods of a mission.

  7. PSYCHE: An Object-Oriented Approach to Simulating Medical Education

    Science.gov (United States)

    Mullen, Jamie A.

    1990-01-01

    Traditional approaches to computer-assisted instruction (CAI) do not provide realistic simulations of medical education, in part because they do not utilize heterogeneous knowledge bases for their source of domain knowledge. PSYCHE, a CAI program designed to teach hypothetico-deductive psychiatric decision-making to medical students, uses an object-oriented implementation of an intelligent tutoring system (ITS) to model the student, domain expert, and tutor. It models the transactions between the participants in complex transaction chains, and uses heterogeneous knowledge bases to represent both domain and procedural knowledge in clinical medicine. This object-oriented approach is a flexible and dynamic approach to modeling, and represents a potentially valuable tool for the investigation of medical education and decision-making.

  8. A vertically integrated geriatric curriculum improves medical student knowledge and clinical skills.

    Science.gov (United States)

    Supiano, Mark A; Fitzgerald, James T; Hall, Karen E; Halter, Jeffrey B

    2007-10-01

    The objective of this study was to determine the effect of a vertically integrated curriculum intervention on the geriatric knowledge and performance in clinical skills of third-year medical students. This observational cohort study conducted at the University of Michigan Medical School evaluates the performance of 622 third-year medical students from the graduating class years of 2004 through 2007. An integrated curriculum intervention was developed and implemented for the class of 2006. Its elements included identification and tracking of geriatric learning outcomes in an individualized Web-based student portfolio, integration of geriatric content into preclinical courses, development of a geriatric functional assessment standardized patient instructor, and an experience in a geriatrics clinic during the ambulatory component of the third-year internal medicine clerkship. Medical student performance was assessed on a geriatric knowledge test and during a geriatric functional assessment station administered during an Observed Structured Clinical Examination (OSCE) at the beginning of the fourth year. Student performance on the geriatric functional assessment OSCE station progressively improved from pre-intervention performance (mean performance+/-standard deviation 43+/-15% class of 2005, 62 + 15% class of 2006, 78+/-10% class of 2007; analysis of variance, P<.001). Similarly, student performance on the geriatric knowledge test was significantly better for the classes of 2006 and 2007 than for the class of 2005 (model F ratio=4.72; P<.001). In conclusion, an integrated approach to incorporating new educational geriatric objectives into the medical school curriculum leads to significant improvements in medical student knowledge and in important clinical skills in the functional assessment of older patients.

  9. Relationship between depression and medication adherence in cardiovascular disease: the perfect challenge for the integrated care team

    Science.gov (United States)

    Goldstein, Carly M; Gathright, Emily C; Garcia, Sarah

    2017-01-01

    Many individuals with cardiovascular disease (CVD) experience depression that is associated with poor health outcomes, which may be because of medication nonadherence. Several factors influence medication adherence and likely influence the relationship between depression and medication adherence in CVD patients. This comprehensive study reviews the existing literature on depression and medication adherence in CVD patients, addresses the methods of and problems with measuring medication adherence, and explains why the integrated care team is uniquely situated to improve the outcomes in depressed CVD patients. This paper also explores how the team can collaboratively target depressive symptoms and medication-taking behavior in routine clinical care. Finally, it suggests the limitations to the integrated care approach, identifies targets for future research, and discusses the implications for CVD patients and their families. PMID:28352161

  10. Towards an integrated approach in supporting microbiological food safety decisions

    DEFF Research Database (Denmark)

    Havelaar, A.H.; Braunig, J.; Christiansen, K.

    2007-01-01

    Decisions on food safety involve consideration of a wide range of concerns including the public health impact of foodborne illness, the economic importance of the agricultural sector and the food industry, and the effectiveness and efficiency of interventions. To support such decisions, we propose...... an integrated scientific approach combining veterinary and medical epidemiology, risk assessment for the farm-to-fork food chain as well as agricultural and health economy. Scientific advice is relevant in all stages of the policy cycle: to assess the magnitude of the food safety problem, to define...... the priorities for action, to establish the causes for the problem, to choose between different control options, to define targets along the food chain and to measure success....

  11. Integrative and Interdisciplinary Approaches to Leadership Development.

    Science.gov (United States)

    Owen, Julie E

    2015-01-01

    Integrating diverse conceptions of leadership across different disciplines, perspectives, and epistemologies is imperative if leaders are to operate in a global and networked world. Interdisciplinary and integrative leadership courses and digital learning communities are featured examples.

  12. An integrated approach to stakeholder engagement.

    Science.gov (United States)

    Carr, Dafna; Howells, Arlene; Chang, Melissa; Hirji, Nadir; English, Ann

    2009-01-01

    The Wait Time Information System (WTIS) project was a complex change-management initiative. For the first time in Ontario, wait time data would be captured directly from clinician offices and publicly reported in an effort to improve access to care. The change meant using new technology, new business processes and, most importantly, a new dimension of accountability for making improvements within the health system. Success required engaging thousands of individuals at all levels of healthcare, many of whom were skeptical and resistant to the upcoming change, and subsequently gaining their support and motivating them to use the WTIS and its data. To achieve the level of stakeholder engagement that would be required to deploy and sustain the WTIS, the project team needed to address both the business reasons for change, and the emotional reactions to it. The team applied a three-pronged approach encompassing strong communications, compelling adoption efforts and hands-on training. Communication focused on awareness and education, ensuring that information was coordinated, consistent and transparent. Adoption efforts involved helping hospitals and users understand and prepare for the impact of change. Training provided hands-on practice to get people comfortable with using the system. This article explores how information management/information technology (IM/IT) projects can integrate communications, adoption and training to drive stakeholder engagement. It also provides insight around how, when used effectively, these functions can maximize limited resources and provide valuable benefits.

  13. An integrative approach to understanding bird origins.

    Science.gov (United States)

    Xu, Xing; Zhou, Zhonghe; Dudley, Robert; Mackem, Susan; Chuong, Cheng-Ming; Erickson, Gregory M; Varricchio, David J

    2014-12-12

    Recent discoveries of spectacular dinosaur fossils overwhelmingly support the hypothesis that birds are descended from maniraptoran theropod dinosaurs, and furthermore, demonstrate that distinctive bird characteristics such as feathers, flight, endothermic physiology, unique strategies for reproduction and growth, and a novel pulmonary system originated among Mesozoic terrestrial dinosaurs. The transition from ground-living to flight-capable theropod dinosaurs now probably represents one of the best-documented major evolutionary transitions in life history. Recent studies in developmental biology and other disciplines provide additional insights into how bird characteristics originated and evolved. The iconic features of extant birds for the most part evolved in a gradual and stepwise fashion throughout archosaur evolution. However, new data also highlight occasional bursts of morphological novelty at certain stages particularly close to the origin of birds and an unavoidable complex, mosaic evolutionary distribution of major bird characteristics on the theropod tree. Research into bird origins provides a premier example of how paleontological and neontological data can interact to reveal the complexity of major innovations, to answer key evolutionary questions, and to lead to new research directions. A better understanding of bird origins requires multifaceted and integrative approaches, yet fossils necessarily provide the final test of any evolutionary model.

  14. Safety in Schools: An Integral Approach

    Science.gov (United States)

    Gairin, Joaquin; Castro, Diego

    2011-01-01

    The present paper summarizes a research project into integral safety in schools. The aims of this particular research are, firstly, to evaluate the degree of integral safety in schools, secondly, to propose means for improving prevention and integral safety systems and thirdly, to identify the characteristics of safety culture. The field work was…

  15. Optimization Routine for Generating Medical Kits for Spaceflight Using the Integrated Medical Model

    Science.gov (United States)

    Graham, Kimberli; Myers, Jerry; Goodenow, Deb

    2017-01-01

    The Integrated Medical Model (IMM) is a MATLAB model that provides probabilistic assessment of the medical risk associated with human spaceflight missions.Different simulations or profiles can be run in which input conditions regarding both mission characteristics and crew characteristics may vary. For each simulation, the IMM records the total medical events that occur and “treats” each event with resources drawn from import scripts. IMM outputs include Total Medical Events (TME), Crew Health Index (CHI), probability of Evacuation (pEVAC), and probability of Loss of Crew Life (pLOCL).The Crew Health Index is determined by the amount of quality time lost (QTL). Previously, an optimization code was implemented in order to efficiently generate medical kits. The kits were optimized to have the greatest benefit possible, given amass and/or volume constraint. A 6-crew, 14-day lunar mission was chosen for the simulation and run through the IMM for 100,000 trials. A built-in MATLAB solver, mixed-integer linear programming, was used for the optimization routine. Kits were generated in 10% increments ranging from 10%-100% of the benefit constraints. Conditions wheremass alone was minimized, volume alone was minimized, and where mass and volume were minimizedjointly were tested.

  16. Internal and external auditing in health systems: an integrative approach.

    Science.gov (United States)

    Mersel, Elie P; Mor-Yosef, Shlomo; Shapira, Shmuel C

    2005-01-01

    Traditionally, auditors are apprehensive when it comes to auditing clinical decisions. A novel model might lead to better integration of auditors into the core activities of health system medical care, while creating common interests among all participants in the process.

  17. Clinical integration and new options for academic medical institutions in network development.

    Science.gov (United States)

    Taylor, P L

    1999-03-01

    The author outlines two options, made possible by developments in antitrust law, that can create a favored role for academic health science centers as well as for stand-alone medical schools and teaching hospitals, using the unique strengths of these institutions that are often considered weaknesses by the marketplace. The first option is the development of clinically integrated collaborations that need not be either system-wide or necessarily governed by total quality management processes, or involve the characteristics of ownership typical of the usual integrated delivery systems. The second option is the development of new clinical "products." Each option encourages creative financing, legal, medical, and governance approaches and makes it possible for centers, medical schools, and teaching hospitals to build multi-provider collaborations that are in harmony with their missions and different from the less-compatible integrated delivery systems that they often seek to build. The author provides an extensive background on antitrust law to explain the two options and the criteria for crafting them within antitrust law. He then describes how antitrust law applies to multi-provider networks and in particular to academic health science centers and free-standing medical schools and teaching hospitals, and gives examples of the kinds of fruitful collaborations these institutions could engage in. He urges those institutions to realize that if they keep faith with their best characteristics in creative new ways (such as those suggested by his article), they will thrive in the years ahead.

  18. Integration of evidence based medicine into the clinical years of a medical curriculum

    Directory of Open Access Journals (Sweden)

    Mazen Ferwana

    2012-01-01

    Full Text Available Teaching Evidence Based Medicine (EBM helps medical students to develop their decision making skills based on current best evidence, especially when it is taught in a clinical context. Few medical schools integrate Evidence Based Medicine into undergraduate curriculum, and those who do so, do it at the academic years only as a standalone (classroom teaching but not at the clinical years. The College of Medicine at King Saud bin Abdulaziz University for Health Sciences was established in January 2004. The college adopted a four-year Problem Based Learning web-based curriculum. The objective of this paper is to present our experience in the integration of the EBM in the clinical phase of the medical curriculum. We teach EBM in 3 steps: first step is teaching EBM concepts and principles, second is teaching the appraisal and search skills, and the last step is teaching it in clinical rotations. Teaching EBM at clinical years consists of 4 student-centered tutorials. In conclusion, EBM may be taught in a systematic, patient centered approach at clinical rounds. This paper could serve as a model of Evidence Based Medicine integration into the clinical phase of a medical curriculum.

  19. An Integrated Computer-Aided Approach for Environmental Studies

    DEFF Research Database (Denmark)

    Gani, Rafiqul; Chen, Fei; Jaksland, Cecilia;

    1997-01-01

    A general framework for an integrated computer-aided approach to solve process design, control, and environmental problems simultaneously is presented. Physicochemical properties and their relationships to the molecular structure play an important role in the proposed integrated approach. The scope...... and applicability of the integrated approach is highlighted through examples involving estimation of properties and environmental pollution prevention. The importance of mixture effects on some environmentally important properties is also demonstrated....

  20. A unified approach to infinite-dimensional integration

    Science.gov (United States)

    Albeverio, S.; Mazzucchi, S.

    2016-04-01

    An approach to infinite-dimensional integration which unifies the case of oscillatory integrals and the case of probabilistic type integrals is presented. It provides a truly infinite-dimensional construction of integrals as linear functionals, as much as possible independent of the underlying topological and measure theoretical structure. Various applications are given, including, next to Feynman path integrals, Schrödinger and diffusion equations, as well as higher order hyperbolic and parabolic equations.

  1. Medical students' attitudes towards the primary health care approach

    African Journals Online (AJOL)

    Medical students' attitudes towards the primary health care approach: what are they, how do they change and ... Journal Home > Vol 49, No 2 (2007) > ... The context of the research presented in this article is the new MBChB curriculum at the ...

  2. Reducing medication errors in critical care: a multimodal approach

    Directory of Open Access Journals (Sweden)

    Kruer RM

    2014-09-01

    Full Text Available Rachel M Kruer,1 Andrew S Jarrell,1 Asad Latif2,3 1Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, USA; 2Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 3Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD, USA Abstract: The Institute of Medicine has reported that medication errors are the single most common type of error in health care, representing 19% of all adverse events, while accounting for over 7,000 deaths annually. The frequency of medication errors in adult intensive care units can be as high as 947 per 1,000 patient-days, with a median of 105.9 per 1,000 patient-days. The formulation of drugs is a potential contributor to medication errors. Challenges related to drug formulation are specific to the various routes of medication administration, though errors associated with medication appearance and labeling occur among all drug formulations and routes of administration. Addressing these multifaceted challenges requires a multimodal approach. Changes in technology, training, systems, and safety culture are all strategies to potentially reduce medication errors related to drug formulation in the intensive care unit. Keywords: medication safety, drug design, drug formulation, patient safety

  3. Integrated optics approach for advanced semiconductor lasers

    Science.gov (United States)

    Suematsu, Yasuharu; Arai, Shigehisa

    1987-11-01

    Recent advances in the field of semiconductor integrated optics are reviewed from the point of view of monolithic integration of semiconductor lasers and other optical components and/or devices. Emphasis is placed on dynamic-single-mode (DSM) lasers, such as DFB and DBR lasers, intended for highly stable single-wavelength light sources for such monolithic integration. The realization of high-performance DSM lasers and the fabrication techniques of monolithically integrated optical devices and circuits are briefly reviewed. A variety of potential applications is discussed.

  4. Medical students’ approaches to learning over a full degree programme

    Directory of Open Access Journals (Sweden)

    William A. Reid

    2012-08-01

    Full Text Available Students take three approaches to learning and studying: deep, surface and strategic, influenced by the learning environment. Following the General Medical Council's report "Tomorrow's Doctors," a deep approach was cultivated in Years 1 and 2 of a university undergraduate medical programme by introducing explicit written learning objectives constructed according to Biggs' SOLO taxonomy, problem-based learning and constructively aligned in-course assignments and examinations. The effect of these changes was measured with the Approaches to Study Skills Inventory for Students (ASSIST. Scores were highest for a deep approach and lowest for a surface approach and showed relatively little change during the degree programme, apart from a slight fall in the scores for a surface approach, particularly for students undertaking an intercalated science degree. Possible explanations include: students' approaches may be established prior to university entry; deep scores were already high at the beginning of the programme and may be difficult to increase further; the changes in learning environment may not be strong enough to alter approaches which students perceive as having been successful.

  5. A semantically-aided approach for online annotation and retrieval of medical images.

    Science.gov (United States)

    Kyriazos, George K; Gerostathopoulos, Ilias Th; Kolias, Vassileios D; Stoitsis, John S; Nikita, Konstantina S

    2011-01-01

    The need for annotating the continuously increasing volume of medical image data is recognized from medical experts for a variety of purposes, regardless if this is medical practice, research or education. The rich information content latent in medical images can be made explicit and formal with the use of well-defined ontologies. Evolution of the Semantic Web now offers a unique opportunity of a web-based, service-oriented approach. Remote access to FMA and ICD-10 reference ontologies provides the ontological annotation framework. The proposed system utilizes this infrastructure to provide a customizable and robust annotation procedure. It also provides an intelligent search mechanism indicating the advantages of semantic over keyword search. The common representation layer discussed facilitates interoperability between institutions and systems, while semantic content enables inference and knowledge integration.

  6. Medical Student Research: An Integrated Mixed-Methods Systematic Review and Meta-Analysis

    Science.gov (United States)

    Amgad, Mohamed; Man Kin Tsui, Marco; Liptrott, Sarah J.; Shash, Emad

    2015-01-01

    Importance Despite the rapidly declining number of physician-investigators, there is no consistent structure within medical education so far for involving medical students in research. Objective To conduct an integrated mixed-methods systematic review and meta-analysis of published studies about medical students' participation in research, and to evaluate the evidence in order to guide policy decision-making regarding this issue. Evidence Review We followed the PRISMA statement guidelines during the preparation of this review and meta-analysis. We searched various databases as well as the bibliographies of the included studies between March 2012 and September 2013. We identified all relevant quantitative and qualitative studies assessing the effect of medical student participation in research, without restrictions regarding study design or publication date. Prespecified outcome-specific quality criteria were used to judge the admission of each quantitative outcome into the meta-analysis. Initial screening of titles and abstracts resulted in the retrieval of 256 articles for full-text assessment. Eventually, 79 articles were included in our study, including eight qualitative studies. An integrated approach was used to combine quantitative and qualitative studies into a single synthesis. Once all included studies were identified, a data-driven thematic analysis was performed. Findings and Conclusions Medical student participation in research is associated with improved short- and long- term scientific productivity, more informed career choices and improved knowledge about-, interest in- and attitudes towards research. Financial worries, gender, having a higher degree (MSc or PhD) before matriculation and perceived competitiveness of the residency of choice are among the factors that affect the engagement of medical students in research and/or their scientific productivity. Intercalated BSc degrees, mandatory graduation theses and curricular research components may

  7. Medical Student Research: An Integrated Mixed-Methods Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Mohamed Amgad

    Full Text Available Despite the rapidly declining number of physician-investigators, there is no consistent structure within medical education so far for involving medical students in research.To conduct an integrated mixed-methods systematic review and meta-analysis of published studies about medical students' participation in research, and to evaluate the evidence in order to guide policy decision-making regarding this issue.We followed the PRISMA statement guidelines during the preparation of this review and meta-analysis. We searched various databases as well as the bibliographies of the included studies between March 2012 and September 2013. We identified all relevant quantitative and qualitative studies assessing the effect of medical student participation in research, without restrictions regarding study design or publication date. Prespecified outcome-specific quality criteria were used to judge the admission of each quantitative outcome into the meta-analysis. Initial screening of titles and abstracts resulted in the retrieval of 256 articles for full-text assessment. Eventually, 79 articles were included in our study, including eight qualitative studies. An integrated approach was used to combine quantitative and qualitative studies into a single synthesis. Once all included studies were identified, a data-driven thematic analysis was performed.Medical student participation in research is associated with improved short- and long- term scientific productivity, more informed career choices and improved knowledge about-, interest in- and attitudes towards research. Financial worries, gender, having a higher degree (MSc or PhD before matriculation and perceived competitiveness of the residency of choice are among the factors that affect the engagement of medical students in research and/or their scientific productivity. Intercalated BSc degrees, mandatory graduation theses and curricular research components may help in standardizing research education during

  8. A streamlined approach for pipeline integrity management

    Energy Technology Data Exchange (ETDEWEB)

    Porter, T.R. [Tuboscope Pipeline Services, Houston, TX (United States); Marr, J.E. [Marr and Associates, A Tuboscope Company, Calgary, AB (Canada)

    2004-07-01

    While regulations call for safe and reliable operation of pipelines, business calls for economic return and reduced liability. This paper presented a system that provides rapid, comprehensive and economic improvements for pipeline integrity decision support. The first phase of a pipeline integrity management plan (IMP) involves the identification of integrity threats to the pipeline. This may involve 22 root causes as defined by the Pipeline Research Council International (PRCI), grouped into 9 categories of related failure types, further grouped into time related defect types. Time dependent defects include external corrosion, internal corrosion and stress corrosion cracking. Stable defects include manufacturing related or welding defects, while time independent defects include mechanical damage, incorrect operations and outside forces. In designing an IMP, high consequence areas (HCAs) must be defined along with the integrity threats that could affect the pipeline. A baseline risk assessment is then performed using data from the integrity threat models to identify risks areas, individual lines, pipe segments or joints. Integrity management decisions are made based on the outcome of initial assessments, resulting in integrity assessment tools such as in line inspection (ILI) technologies, direct assessment (DA), and hydrostatic testing. Pipeline engineers benefit from having ILI, DA and other data integrated and interacting with geographic information system (GIS) data. This paper presented the LinaView PRO{sup TM} IMP tool developed by Tuboscope that enhances dig smart excavation decision making; remediation and mitigation planning; responding to one-call emergency response; implementation of government regulations; HCA identification; integration of a wide variety of data; comprehensive dynamic segmentation; and, data validation in support of risk assessment. The objective of an IMP is the safe and reliable delivery system for oil and gas product to markets. 9

  9. Integrating Medication Therapy Management Education into a Core Pharmacy Curriculum.

    Science.gov (United States)

    Poole, Traci M; Kodali, Leela; Pace, Adam C

    2016-05-25

    Objective. To describe the design of a core course directed at improving confidence and competence of students to perform medication therapy management (MTM) services. Design. Using the American Pharmacists Association (APhA) certificate training program framework, a core course was developed to teach MTM concepts to third-year student pharmacists. Using deep learning and authentic assignments, course instructors attempted to improve student confidence and readiness to provide MTM services. Assessment. Student ability to meet course objectives was evaluated by examinations and the APhA MTM program self-assessment. Students had an overall success rate of 93% on all three assessments. Student perceptions of confidence, competence, and importance of performing MTM services were measured using a survey instrument with 56 Likert-type items. Students completing both surveys reported significantly increased confidence and competence. Conclusion. Integrating MTM-specific education into the core curriculum increased student pharmacists' perceived competence and confidence to perform MTM services.

  10. Data Integration The Relational Logic Approach

    CERN Document Server

    Genesereth, Michael

    2010-01-01

    Data integration is a critical problem in our increasingly interconnected but inevitably heterogeneous world. There are numerous data sources available in organizational databases and on public information systems like the World Wide Web. Not surprisingly, the sources often use different vocabularies and different data structures, being created, as they are, by different people, at different times, for different purposes. The goal of data integration is to provide programmatic and human users with integrated access to multiple, heterogeneous data sources, giving each user the illusion of a sin

  11. The Impact of Technology Integration through a Transformative Approach

    Science.gov (United States)

    Cubillos, Jo Ann

    2013-01-01

    The integration of technology into classroom instruction in K-12 schools remains problematic. The problems associated with this integration are troubling, as technology integration may change a teacher's pedagogy toward more innovative approaches that increase student achievement. The purpose of this study was to document teachers' experiences as…

  12. Postmodern Implications for Theoretical Integration of Counseling Approaches.

    Science.gov (United States)

    Hansen, James T.

    2002-01-01

    Theoretical integration refers to the conceptual unification of diverse counseling approaches. Contends that the general failure of integrative attempts is a by-product of the modernistic epistemic context in which the systems were considered and proposes an examination of common narrative features of counseling approaches in a postmodern…

  13. Major Approaches to Medical Diagnosis and their Drawbacks

    Directory of Open Access Journals (Sweden)

    Sabina MUNTEANU

    2009-12-01

    Full Text Available The ability to reason within a dynamical environment is of a crucial importance in Artificial Intelligence. Medical diagnosis is a dynamic and very complex field which needs special attention Our quest is for a system for medical diagnosis, that could model its search space efficiently and dynamically, while confronted with sequential tests. We present below some of the major approaches from literature, with their drawbacks, and conclude that a combinative hybridization of a certain type would be useful to overcome the failures.

  14. Integrating Ontological Data Sources Using Viewpoints-Based Approach

    Directory of Open Access Journals (Sweden)

    Bouchra Boulkroun

    2016-12-01

    Full Text Available Within the development of Internet and intranets, information integration from various data sources becomes increasingly important and more challenging issue. Recently, the trend in data integration has favored the semantic integration using ontologies. However, the existing ontology-based approaches do not support the aspect of data multi-representations, which is important in the development of multi-user applications. The motivation of this paper is to address a novel semantic integration approach based on ontologies and viewpoints paradigms. This contribution combines the advantages of existing ontology-based integration approaches while avoiding their drawbacks. The proposed integration approach is evaluated using query processing. Profiles are introduced to offer answers to users according to their viewpoints and choices.

  15. Architecture for Integrated Medical Model Dynamic Probabilistic Risk Assessment

    Science.gov (United States)

    Jaworske, D. A.; Myers, J. G.; Goodenow, D.; Young, M.; Arellano, J. D.

    2016-01-01

    Probabilistic Risk Assessment (PRA) is a modeling tool used to predict potential outcomes of a complex system based on a statistical understanding of many initiating events. Utilizing a Monte Carlo method, thousands of instances of the model are considered and outcomes are collected. PRA is considered static, utilizing probabilities alone to calculate outcomes. Dynamic Probabilistic Risk Assessment (dPRA) is an advanced concept where modeling predicts the outcomes of a complex system based not only on the probabilities of many initiating events, but also on a progression of dependencies brought about by progressing down a time line. Events are placed in a single time line, adding each event to a queue, as managed by a planner. Progression down the time line is guided by rules, as managed by a scheduler. The recently developed Integrated Medical Model (IMM) summarizes astronaut health as governed by the probabilities of medical events and mitigation strategies. Managing the software architecture process provides a systematic means of creating, documenting, and communicating a software design early in the development process. The software architecture process begins with establishing requirements and the design is then derived from the requirements.

  16. Climate change: what competencies and which medical education and training approaches?

    Directory of Open Access Journals (Sweden)

    Bell Erica J

    2010-04-01

    Full Text Available Abstract Background Much research has been devoted to identifying healthcare needs in a climate-changing world. However, while there are now global and national policy statements about the importance of health workforce development for climate change, little has been published about what competencies might be demanded of practitioners in a climate-changing world. In such a context, this debate and discussion paper aims to explore the nature of key competencies and related opportunities for teaching climate change in medical education and training. Particular emphasis is made on preparation for practice in rural and remote regions likely to be greatly affected by climate change. Discussion The paper describes what kinds of competencies for climate change might be included in medical education and training. It explores which curricula, teaching, learning and assessment approaches might be involved. Rather than arguing for major changes to medical education and training, this paper explores well established precedents to offer practical suggestions for where a particular kind of literacy--eco-medical literacy--and related competencies could be naturally integrated into existing elements of medical education and training. Summary The health effects of climate change have, generally, not yet been integrated into medical education and training systems. However, the necessary competencies could be taught by building on existing models, best practice and innovative traditions in medicine. Even in crowded curricula, climate change offers an opportunity to reinforce and extend understandings of how interactions between people and place affect health.

  17. Wilber's Integral Theory and Dossey's Theory of Integral Nursing: An Examination of Two Integral Approaches in Nursing Scholarship.

    Science.gov (United States)

    Shea, Linda; Frisch, Noreen

    2016-09-01

    The purpose of this article is to examine Dossey's theory of integral nursing in relation to its major theoretical source, Wilber's integral theory. Although several nursing scholars have written about integral theory in relation to nursing scholarship and practice, Dossey's theory of integral nursing may be influencing how nurses take up integral theory in a significant way due to an extensive outreach in the holistic nursing community. Despite this wide circulation, the theory of integral nursing has yet to be reviewed in the nursing literature. This article (a) compares Dossey's theory of integral nursing with Wilber's integral theory and (b) contrasts Dossey's integral approach with another integral approach used by other scholars of integral theory. © The Author(s) 2015.

  18. The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Human Space Flight Missions

    Science.gov (United States)

    Kerstman, Eric L.; Minard, Charles; FreiredeCarvalho, Mary H.; Walton, Marlei E.; Myers, Jerry G., Jr.; Saile, Lynn G.; Lopez, Vilma; Butler, Douglas J.; Johnson-Throop, Kathy A.

    2011-01-01

    This slide presentation reviews the Integrated Medical Model (IMM) and its use as a risk assessment and decision support tool for human space flight missions. The IMM is an integrated, quantified, evidence-based decision support tool useful to NASA crew health and mission planners. It is intended to assist in optimizing crew health, safety and mission success within the constraints of the space flight environment for in-flight operations. It uses ISS data to assist in planning for the Exploration Program and it is not intended to assist in post flight research. The IMM was used to update Probability Risk Assessment (PRA) for the purpose of updating forecasts for the conditions requiring evacuation (EVAC) or Loss of Crew Life (LOC) for the ISS. The IMM validation approach includes comparison with actual events and involves both qualitative and quantitaive approaches. The results of these comparisons are reviewed. Another use of the IMM is to optimize the medical kits taking into consideration the specific mission and the crew profile. An example of the use of the IMM to optimize the medical kits is reviewed.

  19. Integrated ultrasound and gamma imaging probe for medical diagnosis

    Science.gov (United States)

    Pani, R.; Pellegrini, R.; Cinti, M. N.; Polito, C.; Orlandi, C.; Fabbri, A.; De Vincentis, G.

    2016-03-01

    In the last few years, integrated multi-modality systems have been developed, aimed at improving the accuracy of medical diagnosis correlating information from different imaging techniques. In this contest, a novel dual modality probe is proposed, based on an ultrasound detector integrated with a small field of view single photon emission gamma camera. The probe, dedicated to visualize small organs or tissues located at short depths, performs dual modality images and permits to correlate morphological and functional information. The small field of view gamma camera consists of a continuous NaI:Tl scintillation crystal coupled with two multi-anode photomultiplier tubes. Both detectors were characterized in terms of position linearity and spatial resolution performances in order to guarantee the spatial correspondence between the ultrasound and the gamma images. Finally, dual-modality images of custom phantoms are obtained highlighting the good co-registration between ultrasound and gamma images, in terms of geometry and image processing, as a consequence of calibration procedures.

  20. An Integrated Model of Care: A Visit to The SPARK Center, a Program of Boston Medical Center

    Science.gov (United States)

    Griest, Christa

    2010-01-01

    This article features The SPARK Center, a program of Boston Medical Center, located in Mattapan, Massachusetts. The Center has pioneered a whole-child approach to address the multi-dimensional needs of Boston's most at-risk children, recognizing that vulnerable children need more than educational supports to flourish. The Center's integrated model…

  1. Ontology-supported processing of clinical text using medical knowledge integration for multi-label classification of diagnosis coding

    CERN Document Server

    Waraporn, Phanu; Clayton, Gareth

    2010-01-01

    This paper discusses the knowledge integration of clinical information extracted from distributed medical ontology in order to ameliorate a machine learning-based multi-label coding assignment system. The proposed approach is implemented using a decision tree based cascade hierarchical technique on the university hospital data for patients with Coronary Heart Disease (CHD). The preliminary results obtained show a satisfactory finding.

  2. Position of the American Dietetic Association: integration of medical nutrition therapy and pharmacotherapy.

    Science.gov (United States)

    2003-10-01

    It is the position of the American Dietetic Association that the application of medical nutrition therapy (MNT) and lifestyle counseling as a part of the Nutrition Care Process is an integral component of the medical treatment for management of specific disease states and conditions and should be the initial step in the management of these situations. If optimal control cannot be achieved with MNT alone and concurrent pharmacotherapy is required, then The Association promotes a team approach to care for clients receiving concurrent MNT and pharmacotherapy and encourages active collaboration among dietetics professionals and other members of the health care team. There are a number of medical conditions, many of them chronic, that will respond to MNT and, therefore, MNT should be the first intervention for these conditions. In addition to being a vital element of the optimal management and control of these conditions, MNT is also a cost-effective method of management. However, because of the long-term nature of these conditions, concurrent pharmacotherapy may become necessary to achieve or maintain optimal control. In cases where this is necessary, MNT should continue to be an integral component of the therapy because it may complement or enhance the therapeutic effectiveness of pharmacotherapy, thereby reducing or eliminating the need for multiple medications. The utilization of a coordinated multidisciplinary team approach is critical to the success of the concurrent use of MNT and pharmacotherapy because of the long-term duration of the treatments, the necessity of monitoring compliance and effectiveness, and the likelihood of multiple medication-nutrient interactions.

  3. SHOULD MEDICAL SIMULATION BE AN INTEGRAL PART OF MEDICAL EDUCATIONAL CURRICULUM? A REVIEW

    Directory of Open Access Journals (Sweden)

    Varsha

    2015-08-01

    Full Text Available With increasing concern about patient safety and focus on quality care delivery, there is a shift of teaching paradigm from bedside teaching to simulation based training. A number of research papers have shown simulation to be a valuable tool and it is eme rging as an educational technique very rapidly. Simulation has increasingly become a part of mainstream postgraduate medical education in most of the western countries. Many centres in USA, UK and Canada have built curricula incorporating simulators in tea ching programs. In India, around twelve to fifteen simulation centres are in existence and are developing new programs in different domains of medicine. Various Medical Councils, professional societies and industries could collaborate to advance medical ed ucation to the next level by developing curricula that employ the technology of simulation to improve clinical skills and assess performance and set a bench mark. For maximal effectiveness, Simulation based education needs to be integrated into the curricu lum and not used as a stand - alone intervention

  4. Numerical approach to multi-loop integrals

    CERN Document Server

    Kato, K; Hamaguchi, N; Ishikawa, T; Koike, T; Kurihara, Y; Shimizu, Y; Yuasa, F

    2012-01-01

    For the calculation of multi-loop Feynman integrals, a novel numerical method, the Direct Computation Method (DCM) is developed. It is a combination of a numerical integration and a series extrapolation. In principle, DCM can handle diagrams of arbitrary internal masses and external momenta, and can calculate integrals with general numerator function. As an example of the performance of DCM, a numerical computation of two-loop box diagrams is presented. Further discussion is given on the choice of control parameters in DCM. This method will be an indispensable tool for the higher order radiative correction when it is tested for a wider class of physical parameters and the separation of divergence is done automatically.

  5. Investigation of Integrated Vehicle Health Management Approaches

    Science.gov (United States)

    Paris, Deidre

    2005-01-01

    This report is to present the work that was performed during the summer in the Advance Computing Application office. The NFFP (NASA Faculty Fellow Program) had ten summer faculty members working on IVHM (Integrated Vehicle Health Management) technologies. The objective of this project was two-fold: 1) to become familiar with IVHM concepts and key demonstrated IVHM technologies; and 2) to integrate the research that has been performed by IVHM faculty members into the MASTLAB (Marshall Avionic Software Test Lab). IVHM is a NASA-wide effort to coordinate, integrate and apply advanced software, sensors and design technologies to increase the level of intelligence, autonomy, and health state of future vehicles. IVHM is an important concept because it is consistent with the current plan for NASA to go to the moon, mars, and beyond. In order for NASA to become more involved in deep exploration, avionic systems will need to be highly adaptable and autonomous.

  6. A cloud-based approach to medical NLP.

    Science.gov (United States)

    Chard, Kyle; Russell, Michael; Lussier, Yves A; Mendonça, Eneida A; Silverstein, Jonathan C

    2011-01-01

    Natural Language Processing (NLP) enables access to deep content embedded in medical texts. To date, NLP has not fulfilled its promise of enabling robust clinical encoding, clinical use, quality improvement, and research. We submit that this is in part due to poor accessibility, scalability, and flexibility of NLP systems. We describe here an approach and system which leverages cloud-based approaches such as virtual machines and Representational State Transfer (REST) to extract, process, synthesize, mine, compare/contrast, explore, and manage medical text data in a flexibly secure and scalable architecture. Available architectures in which our Smntx (pronounced as semantics) system can be deployed include: virtual machines in a HIPAA-protected hospital environment, brought up to run analysis over bulk data and destroyed in a local cloud; a commercial cloud for a large complex multi-institutional trial; and within other architectures such as caGrid, i2b2, or NHIN.

  7. Medical Emergency Team syndromes and an approach to their management

    Science.gov (United States)

    Jones, Daryl; Duke, Graeme; Green, John; Briedis, Juris; Bellomo, Rinaldo; Casamento, Andrew; Kattula, Andrea; Way, Margaret

    2006-01-01

    Introduction Most literature on the medical emergency team (MET) relates to its effects on patient outcome. Less information exists on the most common causes of MET calls or on possible approaches to their management. Methods We reviewed the calling criteria and clinical causes of 400 MET calls in a teaching hospital. We propose a set of minimum standards for managing a MET review and developed an approach for managing common problems encountered during MET calls. Results The underlying reasons for initiating MET calls were hypoxia (41%), hypotension (28%), altered conscious state (23%), tachycardia (19%), increased respiratory rate (14%) and oliguria (8%). Infection, pulmonary oedema, and arrhythmias featured as prominent causes of all triggers for MET calls. The proposed minimum requirements for managing a MET review included determining the cause of the deterioration, documenting the events surrounding the MET, establishing a medical plan and ongoing medical follow-up, and discussing the case with the intensivist if certain criteria were fulfilled. A systematic approach to managing episodes of MET review was developed based on the acronym 'A to G': ask and assess; begin basic investigations and resuscitation, call for help if needed, discuss, decide, and document, explain aetiology and management, follow-up, and graciously thank staff. This approach was then adapted to provide a management plan for episodes of tachycardia, hypotension, hypoxia and dyspnoea, reduced urinary output, and altered conscious state. Conclusion A suggested approach permits audit and standardization of the management of MET calls and provides an educational framework for the management of acutely unwell ward patients. Further evaluation and validation of the approach are required. PMID:16507153

  8. Approaches to Integrated Building Design Environments

    DEFF Research Database (Denmark)

    Bagger-Petersen, Susanne C; Andersen, Tom

    1996-01-01

    This report discusses functional requirements and specification which needs to be defined and fulfilled to initiate development of an integrated building design environment. The purpose is to outline specifications for further discussion and development. The report documents the first phase...... in an ongoing project at the Technical University of Denmark. The overall project objective is to provide a theoretically well-founded prototype of an integrated IT-system which can serve as a device of feedback from practice and as a test-bed for the developed concept and architecture....

  9. Field theory a path integral approach

    CERN Document Server

    Das, Ashok

    2006-01-01

    This unique book describes quantum field theory completely within the context of path integrals. With its utility in a variety of fields in physics, the subject matter is primarily developed within the context of quantum mechanics before going into specialized areas.Adding new material keenly requested by readers, this second edition is an important expansion of the popular first edition. Two extra chapters cover path integral quantization of gauge theories and anomalies, and a new section extends the supersymmetry chapter, where singular potentials in supersymmetric systems are described.

  10. Managerial process improvement: a lean approach to eliminating medication delivery.

    Science.gov (United States)

    Hussain, Aftab; Stewart, LaShonda M; Rivers, Patrick A; Munchus, George

    2015-01-01

    Statistical evidence shows that medication errors are a major cause of injuries that concerns all health care oganizations. Despite all the efforts to improve the quality of care, the lack of understanding and inability of management to design a robust system that will strategically target those factors is a major cause of distress. The paper aims to discuss these issues. Achieving optimum organizational performance requires two key variables; work process factors and human performance factors. The approach is that healthcare administrators must take in account both variables in designing a strategy to reduce medication errors. However, strategies that will combat such phenomena require that managers and administrators understand the key factors that are causing medication delivery errors. The authors recommend that healthcare organizations implement the Toyota Production System (TPS) combined with human performance improvement (HPI) methodologies to eliminate medication delivery errors in hospitals. Despite all the efforts to improve the quality of care, there continues to be a lack of understanding and the ability of management to design a robust system that will strategically target those factors associated with medication errors. This paper proposes a solution to an ambiguous workflow process using the TPS combined with the HPI system.

  11. Reconstructing medical history: historiographical features, approaches and challenges.

    Science.gov (United States)

    Conti, A A

    2011-01-01

    Medical historiography deals with the concepts, theories, and approaches adopted in the reconstruction and discussion of the history of medicine. The expression has changed through time and according to different scholars and contexts, and it largely depends on the general standpoint from which the medicine of the past is examined. From an Evidence Based History of Medicine perspective, an accurate and complete examination of all available sources must be carried out to draw a picture of the medical theme examined, and, to reach this aim, the issue of the reliability of sources is a preliminary point to take into account. Different historiographical models adopted in the twentieth century will be discussed in this paper. The current ample discussion on the characterising features, methods and challenges of medical historiography documents the wide extent of the debate on the ways available today for the reconstruction of medical history. It also testifies to the relevance, inter-disciplinarity and remarkable vitality of the topic in current academic, scientific and social contexts. Medical and health history is an essential part of current medicine, and the study of the development of medicine through time is an extremely formative experience, which should not be confined to historians and professionals, but which, in appropriate formats and in correct methodological terms, should have full right of citizenship in current health care initiatives.

  12. Practice and thinking of the integrated curriculum of medical genetics and embryonic development

    Institute of Scientific and Technical Information of China (English)

    Ming-min GU; Zhi-de DING; Hong XU; Lei HUANG; Zhao-yuan HOU; Ying-yin NI

    2015-01-01

    Objective To draw a conclusion from the experience on the integrated curriculum of medical genetics and embryonic development set up for the eight-year clinical medicine,and to lay the foundation for its application to the five-year clinical medicine. Methods The advantages and disadvantages of the integrated curriculumof medical genetics and embryonic development were analyzed with the comparative analysis method. And opinions of students of the eight-year clinical medicine on the teaching of the current integrated curriculum were learnt about with questionnaires. Results The current integrated curriculum of medical genetics and embryonic development has basically achieved the goal of simplifying the original teaching contents and the crossing and integration of the related discipline contents,the overall student satisfaction is high. Conclusion The integrated curriculum of medical genetics and embryonic development is helpful for the integral optimization of the medical curriculum framework,which can be expanded to the five-year clinical medicine in the future.

  13. Design of Integrated Circuits Approaching Terahertz Frequencies

    DEFF Research Database (Denmark)

    Yan, Lei

    In this thesis, monolithic microwave integrated circuits(MMICs) are presented for millimeter-wave and submillimeter-wave or terahertz(THz) applications. Millimeter-wave power generation from solid state devices is not only crucial for the emerging high data rate wireless communications but also...

  14. Development of Multisensory Integration Approach Model

    Science.gov (United States)

    Kumar, S. Prasanna; Nathan, B. Sami

    2016-01-01

    Every teacher expects optimum level of processing in mind of them students. The level of processing is mainly depends upon memory process. Most of the students have retrieval difficulties on past learning. Memory difficulties directly related to sensory integration. In these circumstances the investigator made an attempt to construct Multisensory…

  15. Integrative Life Planning: A Holistic Approach

    Science.gov (United States)

    Hansen, Sunny Sundal

    2011-01-01

    This article presents a brief description of integrative life planning (ILP), the career theory/concept created in the 1990s by the author. It describes what she calls "the heart of ILP," the 6 critical life tasks and their applications.

  16. Ramjets: Thermal Management an Integrated Engineering Approach

    Science.gov (United States)

    2010-09-01

    and Thermal Management (Propulsion a vitesse elevee : Conception du moteur - integration et gestion thermique ) 14. ABSTRACT Within the framework of...a central body extending from the nose tip to the end of the plug nozzle. At the front end of the annular combustor the fuel (assumed to be Jet-A

  17. Some Approaches for Integration of Specification Techniques

    DEFF Research Database (Denmark)

    Haxthausen, Anne Elisabeth

    2000-01-01

    It is often useful to apply several specification techniques within the same software development project. This raises the question how specification techniques can be integrated. In this presentation we give three different examples of how this can be done. In the first example, we summarise how...

  18. A Symmetric Approach Elucidates Multisensory Information Integration

    Directory of Open Access Journals (Sweden)

    Arturo Tozzi

    2016-12-01

    Full Text Available Recent advances in neuronal multisensory integration suggest that the five senses do not exist in isolation of each other. Perception, cognition and action are integrated at very early levels of central processing, in a densely-coupled system equipped with multisensory interactions occurring at all temporal and spatial stages. In such a novel framework, a concept from the far-flung branch of topology, namely the Borsuk-Ulam theorem, comes into play. The theorem states that when two opposite points on a sphere are projected onto a circumference, they give rise to a single point containing their matching description. Here we show that the theorem applies also to multisensory integration: two environmental stimuli from different sensory modalities display similar features when mapped into cortical neurons. Topological tools not only shed new light on questions concerning the functional architecture of mind and the nature of mental states, but also provide an empirically assessable methodology. We argue that the Borsuk-Ulam theorem is a general principle underlying nervous multisensory integration, resulting in a framework that has the potential to be operationalized.

  19. Integrated approach to economical, reliable, safe nuclear power production

    Energy Technology Data Exchange (ETDEWEB)

    1982-06-01

    An Integrated Approach to Economical, Reliable, Safe Nuclear Power Production is the latest evolution of a concept which originated with the Defense-in-Depth philosophy of the nuclear industry. As Defense-in-Depth provided a framework for viewing physical barriers and equipment redundancy, the Integrated Approach gives a framework for viewing nuclear power production in terms of functions and institutions. In the Integrated Approach, four plant Goals are defined (Normal Operation, Core and Plant Protection, Containment Integrity and Emergency Preparedness) with the attendant Functional and Institutional Classifications that support them. The Integrated Approach provides a systematic perspective that combines the economic objective of reliable power production with the safety objective of consistent, controlled plant operation.

  20. An Approach for Learning Expressive Ontologies in Medical Domain.

    Science.gov (United States)

    Rios-Alvarado, Ana B; Lopez-Arevalo, Ivan; Tello-Leal, Edgar; Sosa-Sosa, Victor J

    2015-08-01

    The access to medical information (journals, blogs, web-pages, dictionaries, and texts) has been increased due to availability of many digital media. In particular, finding an appropriate structure that represents the information contained in texts is not a trivial task. One of the structures for modeling the knowledge are ontologies. An ontology refers to a conceptualization of a specific domain of knowledge. Ontologies are especially useful because they support the exchange and sharing of information as well as reasoning tasks. The usage of ontologies in medicine is mainly focussed in the representation and organization of medical terminologies. Ontology learning techniques have emerged as a set of techniques to get ontologies from unstructured information. This paper describes a new ontology learning approach that consists of a method for the acquisition of concepts and its corresponding taxonomic relations, where also axioms disjointWith and equivalentClass are learned from text without human intervention. The source of knowledge involves files about medical domain. Our approach is divided into two stages, the first part corresponds to discover hierarchical relations and the second part to the axiom extraction. Our automatic ontology learning approach shows better results compared against previous work, giving rise to more expressive ontologies.

  1. An integrative approach to apprehend desistance.

    Science.gov (United States)

    F-Dufour, Isabelle; Brassard, Renée; Martel, Joane

    2015-05-01

    The process underlying desistance is still a strong subject of debate. This article seeks to introduce several core concepts of Archer's morphogenic approach to study how people desist from crime. At first, it discusses the primary existing theories of desistance. Then, this article demonstrates the usefulness of this approach by presenting empirical evidence drawn from semistructured interviews collected with 29 men who desisted from crime in an eastern province of Canada. The study demonstrates how this alternative approach allows for the consolidation of existing knowledge on desistance. Then implication of these findings for both theory and practice are discussed.

  2. Valuing groundwater: A practical approach for integrating ...

    African Journals Online (AJOL)

    groundwater economic values into decision making ... The methodology incorporates a 2-tiered valuation approach. .... groundwater systems in Botswana (SADC, 2010). .... tion) can be investigated to support water resource management.

  3. Mental health provider perspectives regarding integrated medical care for patients with serious mental illness.

    Science.gov (United States)

    Kilbourne, Amy M; Greenwald, Devra E; Bauer, Mark S; Charns, Martin P; Yano, Elizabeth M

    2012-11-01

    Integrated care for medical conditions is essential for persons with serious mental illness (SMI). This qualitative study describes mental health provider perspectives regarding barriers and facilitators of integrated care for patients with SMI. We interviewed providers from a national sample of Veterans Health Administration facilities that scored in the top or bottom percentile in medical care quality. Providers from high-performing sites reported substantial in-person contacts with general medical providers, while providers from low-performing sites reported stigma and limited communication with medical providers as major concerns. Interventions to improve mental health and medical provider communication may facilitate integrated care for persons with SMI.

  4. Approaches in integrative bioinformatics towards the virtual cell

    CERN Document Server

    Chen, Ming

    2014-01-01

    Approaches in Integrative Bioinformatics provides a basic introduction to biological information systems, as well as guidance for the computational analysis of systems biology. This book also covers a range of issues and methods that reveal the multitude of omics data integration types and the relevance that integrative bioinformatics has today. Topics include biological data integration and manipulation, modeling and simulation of metabolic networks, transcriptomics and phenomics, and virtual cell approaches, as well as a number of applications of network biology. It helps to illustrat

  5. A Path Integral Approach To Noncommutative Superspace

    CERN Document Server

    Chepelev, I; Chepelev, Iouri; Ciocarlie, Calin

    2003-01-01

    A path integral formula for the associative star-product of two superfields is proposed. It is a generalization of the Kontsevich-Cattaneo-Felder's formula for the star-product of functions of bosonic coordinates. The associativity of the star-product imposes certain conditions on the background of our sigma model. For generic background the action is not supersymmetric. The supersymmetry invariance of the action constrains the background and leads to a simple formula for the star-product.

  6. Integrated approaches to warehouse planning and operations

    OpenAIRE

    Geraldes, Carla A. S.

    2010-01-01

    In this talk we discuss a tactical model recently available in warehouse literature. The model integrates the replenishment decision in inventory management, the allocation of products to warehousing systems and the assignment of products to storage locations in warehousing management. Our aim is to show the models’ potentialities and weaknesses when applied to a wide variety of problems and to identify challenging research opportunities for developing global warehouse decision support mod...

  7. The line integral approach to radarclinometry

    Science.gov (United States)

    Wildey, R.L.

    1987-01-01

    Radarclinometry, the invention of which has been previously reported, is a technique for deriving a topographic map from a single radar image by using the dependence upon terrain-surface orientation of the integrated signal of an individual image pixel. The radiometric calibration required for precise operation and testing does not yet exist, but the imminence of important applications justifies parallel, rather than serial, development of radarclinometry and radiometrically calibrated radar. The present investigation reports three developmental advances: (1) The solid angle of integration of back-scattered specific intensity constituting a pixel signal is more accurately accounted for in its dependence on surface orientation than in previous work. (2) The local curvature hypothesis, which removes the requirement of a ground-truth profile as a boundary condition and enables the formulation of the theory in terms of a line integral, has been expanded to include the three possibilities of Local Cylindricity, Local Biaxial Ellipsoidal Hyperbolicity, and Least-Squares Local Sphericity. (3) The theory is integrated in the cross-ground-range direction, which is ill-conditioned compared to the ground-range direction, whereas the original formulation was based on enforced isotropy in the two-dimensional power spectrum of the topography. It was found necessary to prohibit the hypothesis of Local Biaxial Ellipsoidal Hyperbolicity in the cross-range stepping, for reasons not completely clear. Variation in the proportioning between curvature assumptions had produced topographic maps that are in good mutual agreement but not realistic in appearance. They are severely banded parallel to the ground-range direction, most especially at small radar zenith angles. Numerical experimentation with the falsification of topography through incorrect decalibration as performed on a Gaussian hill suggests that the banding and its exaggeration at high radar incidence angles could easily be

  8. Integrated care for diabetes - The Singapore Approach

    Directory of Open Access Journals (Sweden)

    Su Qian Yeo

    2012-03-01

    Full Text Available Background The prevalence of diabetes mellitus is 12.7% in Singapore. Managing people with diabetes in the community may be needed to reduce unnecessary utilisation of expensive specialist resources and to reduce hospital waiting times for patients with complications. Care Practice The Singapore General Hospital (SGH Delivering on Target (DOT Programme was launched in 2005 to right-site clinically stable diabetic patients from the hospital to private DOT GPs. The Chronic Disease Management Office (CDMO was established and a fully customised DOT information technology (IT system was developed. Three initiatives were implemented: (i Subsidised Drug Delivery Programme, (ii Diagnostic Tests Incentive Programme, and (iii Allied Healthcare Incentive Programme. Discussion Right-siting was enabled through patient incentives that eased the burden of out-of-pocket expenditure. Right Siting Officers (RSOs maintained a general oversight of the patient pathway. The integrated system supported shared care follow-up by enabling DOT GPs to share updates on the patients' health status with the referring specialists. Conclusion A coherent process across all healthcare providers similar to the SGH DOT Programme may facilitate efforts to shift the care for people with diabetes to the community and to provide integrated care. Successful integration may require incentives for institutional partners and patients.

  9. Concept for integrated environmental monitoring. Scientific approach

    Energy Technology Data Exchange (ETDEWEB)

    Haber, W. [comp.; Schoenthaler, K.; Kerner, H.F.; Koeppel, J.; Spandau, L.

    1998-09-01

    Despite considerable expenditures for environmental protection and intensified efforts in the areas of environmental research and monitoring, environmental damage increasingly occurs, sometimes with global effects, largely due to the lack of early diagnosis. In the past few years various institutions have therefore demanded improvements in environmental monitoring. The Council of Experts on Environmental Issues (`Rat von Sachverstaendigen fuer Umweltfragen`, SRU), in particular, in its `Environmental Report` of 1987 and in its Special Report on `General Ecological Environmental Monitoring` (1990) presented far-reaching demands for a nationwide ecological early warning system which should integrate the various local, regional, national, and even global monitoring levels, and which should encompass an environmental monitoring of entire ecosystems at representative locations. This is aimed at creating the prerequisites for - detection of long-term gradual environmental change, - confirmation of refutation of initial assumptions regarding the causes of these environmental changes, - permitting decisions on preventive actions to stabilize or improve environmental conditions and - making it possible to assess the success of environmental protection policies. This report includes an abbreviated version and documentation of the conference on the `Concept for Integrated Environmental Monitoring` and the final report `Specification of the Concept for Integrated Environmental Monitoring from the Perspective of Nature Conservation`. (orig.)

  10. Dysphonia: medical treatment and a medical voice hygiene advice approach. A prospective randomised pilot study.

    Science.gov (United States)

    Pedersen, M; Beranova, A; Møller, S

    2004-07-01

    For many years all patients with dysphonia referred to in the literature as resulting from non-organic (functional) voice disorders were sent to speech therapy. Medical diagnoses were not taken into account. In our earlier Cochrane review on vocal cord nodules we discovered that evidence-based research in the area of benign voice disorders with dysphonia, and with or without slight benign swellings including nodules on the vocal cords, was lacking at that time. Therefore, a prospective randomised pilot study based on our Cochrane review has been made on dysphonic patients with non-organic (function provoked?) voice disorders as the basis for further evidence-based studies. Medical treatment was based on the scientific approach that once a micro-organic disorder caused by reflux, infection, allergy or environmental irritatants (e.g., dust or noise in the workplace) was discovered by very careful anamnesis and systematic objective routine analyses and was treated effectively, with documentation, the non-organic voice disorder disappeared, as, e.g., in the case of a diagnosis and treatment of helicobakter pylori. The reason is that the mucosal swelling/dysfunction of the vocal cords is secondary. In order to try to understand why the recommendation to all these patients for many years was only voice therapy, which the speech therapists "felt to be effective", updated voice-hygiene advice (for posture, accents of the diaphragm, intonation pattern and resonance) was given by experienced laryngologists, randomised with the updated medical diagnosis/therapy in order to elucidate what effect the training might have. No evidence-based studies in the literature document any effect. The crucial point seemed to be that doctors mostly did not examine any other diagnoses other than the "dysphonia" and did not dig down to any of the medical reasons when the vocal fold diagnosis of "non- organic disorders" was made. This should be changed in the future. This pilot study was based

  11. Integrated medical-psychiatric care of a dying borderline patient: a case of dynamically informed "practical psychotherapy".

    Science.gov (United States)

    Lacy, Timothy J; Higgins, Michael J

    2005-01-01

    Combined training in family practice and psychiatry is relatively new and consists of equal proportions of each specialty intermixed throughout a 5-year period. This blending of two distinct skill sets and patient populations creates opportunities to provide unique patient care. An understanding of psychodynamic principles is vital to treating patients with comorbid medical and psychiatric illnesses in a primary care setting. The patient presented in this article had several medical and psychiatric problems and was treated by a combined family practice-psychiatry resident who cared for her medically and psychiatrically until the time of her death from cancer. Complex patients such as this defy the use of purely applied school-specific psychotherapies. Rather, they require the creative application of integrated psychotherapeutic strategies. Integrated approaches to psychotherapy have been increasingly advocated in recent years. In keeping with terminology used by Carl Jung, this approach may be thought of simply as practical psychotherapy.

  12. Canadian National Guidelines and Recommendations for Integrating Career Advising Into Medical School Curricula.

    Science.gov (United States)

    Howse, Kelly; Harris, June; Dalgarno, Nancy

    2017-04-25

    Career planning, decision making about specialty choice, and preparation for residency matching are significant sources of stress for medical students. Attempts have been made to structure and formalize career advising by including it in accreditation standards. There is an expressed need for national guidelines on career advising for medical students. The Future of Medical Education in Canada Postgraduate (FMEC PG) Implementation Project was created to ensure Canadian medical trainees receive the best education possible. From this, a diverse sub-working group (SWG), representing different Canadian regions, was formed to review career advising processes across the country. The SWG developed, through a modified formal consensus methodology, a strategy for medical student career advising that is adaptable to all schools in alignment with existing accreditation standards. The SWG outlined five guiding principles and five essential elements for Canadian universities offering an MD degree with recommendations on how to integrate the elements into each school's career advising system. The five essential elements are a structured approach to career advising, information about available career options, elective guidance, preparation for residency applications, and social accountability. This Perspective endorses the view of the FMEC PG Implementation Project that national guidelines are important to ensure Canadian medical schools are consistently meeting accreditation standards by providing reliable and quality career advising to all medical students. The SWG's position, based on national and provincial feedback, is that these guidelines will stimulate discourse and action regarding the requirements and processes to carry out these recommendations nationwide and share across borders.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and

  13. Complementary medicines in medicine: Conceptualising terminology among Australian medical students using a constructivist grounded theory approach.

    Science.gov (United States)

    Templeman, Kate; Robinson, Anske; McKenna, Lisa

    2015-02-01

    Terminology around the use of complementary medicines (CM) within medical discourse is ambiguous. Clear collective discourse within the medical context is required. This study reports the findings of a Constructivist Grounded Theory Method study used to explore medical students' conceptualisation of terminology and associated value components around CMs as evidenced within their discourse community. The results show that terminology surrounding CMs within medicine is politically charged and fraught with value judgements. Terms used to describe CMs were considered, many of which were deemed problematic. Categorisation of specific medicines was also deemed inappropriate in certain contexts. Conceptualisation of CM terminology, categorisation and value implications, discriminated between levels of evidence for CMs and provided insights into the social change of medicine towards emergence of an evidence-based integrative approach. The results show that terminology surrounding CM is a social construct consistent with fluid conceptualisation and operationalisation in different social contexts.

  14. A Semi-automated Approach to Improve the Efficiency of Medical Imaging Segmentation for Haptic Rendering.

    Science.gov (United States)

    Banerjee, Pat; Hu, Mengqi; Kannan, Rahul; Krishnaswamy, Srinivasan

    2017-08-01

    The Sensimmer platform represents our ongoing research on simultaneous haptics and graphics rendering of 3D models. For simulation of medical and surgical procedures using Sensimmer, 3D models must be obtained from medical imaging data, such as magnetic resonance imaging (MRI) or computed tomography (CT). Image segmentation techniques are used to determine the anatomies of interest from the images. 3D models are obtained from segmentation and their triangle reduction is required for graphics and haptics rendering. This paper focuses on creating 3D models by automating the segmentation of CT images based on the pixel contrast for integrating the interface between Sensimmer and medical imaging devices, using the volumetric approach, Hough transform method, and manual centering method. Hence, automating the process has reduced the segmentation time by 56.35% while maintaining the same accuracy of the output at ±2 voxels.

  15. Elderly patient refractory to multiple pain medications successfully treated with integrative East–West medicine

    Directory of Open Access Journals (Sweden)

    Bill Tu

    2008-07-01

    Full Text Available Bill Tu, Michael Johnston, Ka-Kit HuiUCLA Center for East–West Medicine, Department of Internal Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USABackground: Polypharmacy is a common and serious problem in the elderly today. Few solutions have been effective in reducing its incidence.Case summary: An 87-year-old female with a history of osteoarthritis and spinal stenosis presented with a five month history of severe right hip pain. She had been seen by multiple specialists and hospitalized many times. During these encounters, she was prescribed a long list of pain medications. However, these medications did not improve her pain and added to her risk of adverse drug events. After exhausting traditional Western medical therapies, she received a referral to the UCLA Center for East–West Medicine. There, clinicians treated her with a nonpharmacological integrative East-West medicine approach that included acupuncture, dry needling of trigger points, and education on self-acupressure. Her pain began improving and she was able to cut back on analgesic use under physician supervision. Ultimately, she improved to the point where she was able to discontinue all of her pain medications. Symptomatic relief was evidenced by improvement in health-related quality of life (HRQOL.Conclusions: This case study suggests that integrative East–West medicine may have the potential to reduce the incidence of polypharmacy in elderly patients presenting with pain conditions and improve their quality of life.Keywords: polypharmacy, pain, osteoarthritis, acupuncture, complementary and alternative medicine, integrative medicine, adverse drug reaction, elderly

  16. Founding Editorial: Embryology — An Integrated Approach

    Directory of Open Access Journals (Sweden)

    Michael Richardson

    2001-01-01

    Full Text Available We introduce the Embryology domain of TheScientificWorld and outline the scope and aims. We argue for an interdisciplinary approach to problems in develop-mental biology. Three areas are identified as being of particular relevance to this domain: evolutionary developmental biology, teratology, and descriptive or experimental embryology.

  17. New Theoretical Approach Integrated Education and Technology

    Science.gov (United States)

    Ding, Gang

    2010-01-01

    The paper focuses on exploring new theoretical approach in education with development of online learning technology, from e-learning to u-learning and virtual reality technology, and points out possibilities such as constructing a new teaching ecological system, ubiquitous educational awareness with ubiquitous technology, and changing the…

  18. ESCO in Danish municipalities: Basic, integrative or strategic approaches?

    DEFF Research Database (Denmark)

    Jensen, Jesper Ole; Hansen, Jesper Rohr

    2012-01-01

    , with relatively few buildings, energy retrofitting and low investments, the integrative and strategic approach include a higher degree of partnership, a more ambitious building renovation approach, and more innovative understandings of facilities management. We also compare ESCO with energy retrofitting as an in...... municipalities see an in-house approach as a better alternative. Approach (Theory/Methodology): Our research is based on literature studies and on qualitative interviews with Danish municipalities carrying out ESCO projects, as well as with ESCO providers. Results: Our studies suggest that different ESCO...... approaches are being used in Danish municipalities, which we label the basic, the integrated and the strategic ESCO approaches. The three approaches include different ambitions, technologies, economies and innovation potentials. Whereas the basic approach implies a ‘traditional’ guarantee-based model...

  19. Application of integral imaging autostereoscopic display to medical training equipment

    Science.gov (United States)

    Nagatani, Hiroyuki

    2010-02-01

    We applied an autostereoscopic display based on the integral imaging method (II method) to training equipment for medical treatment in an attempt to recover the binocular vision performance of strabismus or amblyopia (lazy eye) patients. This report summarizes the application method and results. The point of the training is to recognize the parallax using both eyes. The strabismus or amblyopia patients have to recognize the information on both eyes equally when they gaze at the display with parallax and perceive the stereo depth of the content. Participants in this interactive training engage actively with the image. As a result, they are able to revive their binocular visual function while playing a game. Through the training, the observers became able to recognize the amount of parallax correctly. In addition, the training level can be changed according to the eyesight difference between a right eye and a left eye. As a result, we ascertained that practical application of the II method for strabismus or amblyopia patients would be possible.

  20. An interprofessional approach to improving paediatric medication safety

    Directory of Open Access Journals (Sweden)

    Kennedy Neil

    2010-02-01

    Full Text Available Abstract Background Safe drug prescribing and administration are essential elements within undergraduate healthcare curricula, but medication errors, especially in paediatric practice, continue to compromise patient safety. In this area of clinical care, collective responsibility, team working and communication between health professionals have been identified as key elements in safe clinical practice. To date, there is limited research evidence as to how best to deliver teaching and learning of these competencies to practitioners of the future. Methods An interprofessional workshop to facilitate learning of knowledge, core competencies, communication and team working skills in paediatric drug prescribing and administration at undergraduate level was developed and evaluated. The practical, ward-based workshop was delivered to 4th year medical and 3rd year nursing students and evaluated using a pre and post workshop questionnaire with open-ended response questions. Results Following the workshop, students reported an increase in their knowledge and awareness of paediatric medication safety and the causes of medication errors (p Conclusion This study has helped bridge the knowledge-skills gap, demonstrating how an interprofessional approach to drug prescribing and administration has the potential to improve quality and safety within healthcare.

  1. Urban energy systems an integrated approach

    CERN Document Server

    Keirstead, James

    2013-01-01

    Energy demands of cities need to be met more sustainably. This book analyses the technical and social systems that satisfy these needs and asks how methods can be put into practice to achieve this.Drawing on analytical tools and case studies developed at Imperial College London, the book presents state-of-the-art techniques for examining urban energy systems as integrated systems of technologies, resources, and people.Case studies include:a history of the evolution of London's urban energy system, from pre-history to present daya history of the growth of d

  2. The Role of an Integrated Approach in Music Education Technology

    Directory of Open Access Journals (Sweden)

    Natalia Popovych

    2014-04-01

    Full Text Available The purpose of this paper is to justify the role of integrated approach to music education of students. This requires the implementation of a theoretical analysis of the meaning and importance of an integrated approach to music education and training, determination of didactic conditions of integrating the music education in schools and coverage of methods of arrangement of the complex relationships of the main types of educational and creative activity for students in music lessons. It is proved that an integrated approach to the music education process causes the appearance of new original teaching forms and techniques that brings the process to a new qualitative level, enriching the musical and creative abilities of students, enabling them to realize the artistic and aesthetic taste preferences, to achieve the integrity of musical and creative development and high levels of formation of aesthetic consciousness and music.

  3. Semantic Health Knowledge Graph: Semantic Integration of Heterogeneous Medical Knowledge and Services

    Directory of Open Access Journals (Sweden)

    Longxiang Shi

    2017-01-01

    Full Text Available With the explosion of healthcare information, there has been a tremendous amount of heterogeneous textual medical knowledge (TMK, which plays an essential role in healthcare information systems. Existing works for integrating and utilizing the TMK mainly focus on straightforward connections establishment and pay less attention to make computers interpret and retrieve knowledge correctly and quickly. In this paper, we explore a novel model to organize and integrate the TMK into conceptual graphs. We then employ a framework to automatically retrieve knowledge in knowledge graphs with a high precision. In order to perform reasonable inference on knowledge graphs, we propose a contextual inference pruning algorithm to achieve efficient chain inference. Our algorithm achieves a better inference result with precision and recall of 92% and 96%, respectively, which can avoid most of the meaningless inferences. In addition, we implement two prototypes and provide services, and the results show our approach is practical and effective.

  4. Lossless watermarking of categorical attributes for verifying medical data base integrity.

    Science.gov (United States)

    Coatrieux, G; Chazard, E; Beuscart, R; Roux, C

    2011-01-01

    In this article, we propose a new lossless or reversible watermarking approach that allows the embedding of a message within categorical data of relational database. The reversibility property of our scheme is achieved by adapting the well known histogram shifting modulation. Based on this algorithm we derive a system for verifying the integrity of the database content, it means detecting addition, removal or modification of any t-uples or attributes. Such a content integrity check is independent of the manner the database is stored or structured. We illustrate the overall capability of our method and its constraints of deployment considering one medical database of inpatient hospital stay records. Especially, we reversibly watermark ICD-10 diagnostic codes.

  5. A multi-site approach towards integrating environmental ...

    African Journals Online (AJOL)

    A multi-site approach towards integrating environmental management in the wine ... of environmental performance key indicators, especially in water consumption ... some effluent quality improvements through better wastewater management, ...

  6. A geometric approach to integrability conditions for Riccati equations

    Directory of Open Access Journals (Sweden)

    Arturo Ramos

    2007-09-01

    Full Text Available Several instances of integrable Riccati equations are analyzed from the geometric perspective of the theory of Lie systems. This provides us a unifying viewpoint for previous approaches.

  7. ONTOLOGY INTEGRATION APPROACHES AND ITS IMPACT ON TEXT CATEGORIZATION

    Directory of Open Access Journals (Sweden)

    Hamid Machhour

    2013-05-01

    Full Text Available This article will introduce some approaches for improving text categorization models by integrating previously imported ontologies. From the Reuters Corpus Volume I (RCV1 dataset, some categories very similar in content and related to telecommunications, Internet and computer areas were selected for models experiments. Several domain ontologies, covering these areas were built and integrated to categorization models for their improvements.

  8. A Path Integral Approach to Inclusive Processes

    CERN Document Server

    Nachtmann, O

    2000-01-01

    The single-particle inclusive differential cross-section for a reaction$a+b\\to c+X$ is written as the imaginary part of a correlation function in afor ward scattering amplitude for $a+b\\to a+b$ in a modified effective theory.In this modified theory the interaction Hamiltonian $\\tilde H_I$ equals $H_I$in the original theory up to a certain time. Then there is a sign change and$\\tilde H_I$ becomes nonlocal. This is worked out in detail for scalar fieldmodels and for QED plus the abelian gluon model. A suitable path integral fordirect calculations of inclusive cross sections is presented.

  9. Integrating Geriatrics into Medical School: Student Journaling as an Innovative Strategy for Evaluating Curriculum

    Science.gov (United States)

    Shield, Renee R.; Farrell, Timothy W.; Nanda, Aman; Campbell, Susan E.; Wetle, Terrie

    2012-01-01

    Purpose of the study: The Alpert Medical School of Brown University began to integrate geriatrics content into all preclerkship courses and key clerkship cases as part of a major medical school curriculum redesign in 2006. This study evaluates students' responses to geriatrics integration within the curriculum using journals kept by volunteer…

  10. Psychiatry in the Harvard Medical School-Cambridge Integrated Clerkship: An Innovative, Year-Long Program

    Science.gov (United States)

    Griswold, Todd; Bullock, Christopher; Gaufberg, Elizabeth; Albanese, Mark; Bonilla, Pedro; Dvorak, Ramona; Epelbaum, Claudia; Givon, Lior; Kueppenbender, Karsten; Joseph, Robert; Boyd, J. Wesley; Shtasel, Derri

    2012-01-01

    Objective: The authors present what is to their knowledge the first description of a model for longitudinal third-year medical student psychiatry education. Method: A longitudinal, integrated psychiatric curriculum was developed, implemented, and sustained within the Harvard Medical School-Cambridge Integrated Clerkship. Curriculum elements…

  11. Integrating Geriatrics into Medical School: Student Journaling as an Innovative Strategy for Evaluating Curriculum

    Science.gov (United States)

    Shield, Renee R.; Farrell, Timothy W.; Nanda, Aman; Campbell, Susan E.; Wetle, Terrie

    2012-01-01

    Purpose of the study: The Alpert Medical School of Brown University began to integrate geriatrics content into all preclerkship courses and key clerkship cases as part of a major medical school curriculum redesign in 2006. This study evaluates students' responses to geriatrics integration within the curriculum using journals kept by volunteer…

  12. Towards an integrated approach to health and medicine in Africa.

    Science.gov (United States)

    Batisai, Kezia

    2016-12-01

    This article frames the intersections of medicine and humanities as intrinsic to understanding the practice of health care in Africa. Central to this manuscript, which draws on empirical findings on the interplay between HIV and AIDS and alternative medicine in Zimbabwe is the realisation that very limited research has been undertaken to examine 'HIV/AIDS patient behaviour' with respect to choice of therapy on the continent [Bene, M. & Darkoh, M. B. K. (2014). The Constraints of Antiretroviral Uptake in Rural Areas: The Case of Thamaga and Surrounding Villages, Botswana. Journal of Social Aspects of HIV/AIDS, 11(1), 167-177. doi: 10.1080/17290376.2014.972057 ; Chavunduka, G. (1998). Professionalisation of Traditional Medicine in Zimbabwe, Harare, Jongwe Printers; O'Brien, S. & Broom, A. (2014). HIV in (and out of) the Clinic: Biomedicine, Traditional Medicine and Spiritual Healing in Harare. Journal of Social Aspects of HIV/AIDS, 11(1), 94-104. doi: 10.1080/17290376.2014.938102 ]. As such, a social approach to health-seeking behaviour questions how decisions about alternative therapies including herbal remedies, traditional healing and faith healing are made. The paper unpacks the realities around how people living with HIV and AIDS - who span different age groups and profess various religious backgrounds, faced with an insurmountable health challenge against a background of limited resources and no cure for the virus - often experience shifts in health-seeking behaviour. Grappling with seemingly simple questions about 'when, where and how to seek medical attention', the paper provides pointers to therapy choices and health-seeking behaviour; and it serves as a route into deeper and intense healthcare practice explorations. In conclusion, the paper proposes that medicine and the humanities should engage seriously with those social aspects of HIV and AIDS which call for an integrated approach to healthcare practice in Africa. If combined, medicine and the humanities

  13. An epidemiologic approach to computerized medical diagnosis--AEDMI program.

    Science.gov (United States)

    Ferrer Salvans, P; Alonso Vallès, L

    1990-01-01

    A program called "An Epidemiological Approach to Computerized Medical Diagnosis" (AEDMI) is presented. Using an interactive questionnaire, physician-patient interviews are conducted and a summary of the relevant clinical data is provided. Standard items, obtained on a multi-centre basis, form a large-scale data base. Simultaneously, the reasoning of clinical experts in each real case is analyzed to obtain a knowledge-rules data base. The methodology of the program combines Bayesian systems, expert systems, and other new lines of research such as neural networks or case-based reasoning. The general concepts of clinical decision making aid systems are reviewed. This publication is aimed at obtaining international cooperation.

  14. Teaching energy using an integrated science approach

    Science.gov (United States)

    Poggi, Valeria; Miceli, Cristina; Testa, Italo

    2017-01-01

    Despite its relevance to all scientific domains, the debate surrounding the teaching of energy is still open. The main point remains the problems students have in understanding some aspects of the energy concept and in applying their knowledge to the comprehension of natural phenomena. In this paper, we present a research-based interdisciplinary approach to the teaching of energy in which the first and second laws of thermodynamics were used to interpret physical, chemical and biological processes. The contents of the three disciplines (physics, chemistry, biology) were reconstructed focusing on six basic aspects of energy (forms, transfer, transformation, conservation, degradation, and entropy) and using common teaching methodologies. The module was assessed with 39 secondary school students (aged 15-16) using a 30-question research instrument and a treatment/control group methodology. Analysis of students’ learning outcomes suggests a better understanding of the energy concept, supporting the effectiveness of an interdisciplinary approach in the teaching of energy in physics and science in general. Implications for the teaching of energy are briefly discussed.

  15. An integrated approach to vulnerability assessment.

    Energy Technology Data Exchange (ETDEWEB)

    Tidwell, Vincent Carroll; Jurado, Sariah Ruth (University of New Mexico, Albuquerque, NM); Silva, Consuelo Juanita

    2005-03-01

    How might the quality of a city's delivered water be compromised through natural or malevolent causes? What are the consequences of a contamination event? What water utility assets are at greatest risk to compromise? Utility managers have been scrambling to find answers to these questions since the events of 9/11. However, even before this date utility mangers were concerned with the potential for system contamination through natural or accidental causes. Unfortunately, an integrated tool for assessing both the threat of attack/failure and the subsequent consequence is lacking. To help with this problem we combine Markov Latent Effects modeling for performing threat assessment calculations with the widely used pipe hydraulics/transport code, EPANET, for consequences analysis. Together information from these models defines the risk posed to the public due to natural or malevolent contamination of a water utility system. Here, this risk assessment framework is introduced and demonstrated within the context of vulnerability assessment for water distribution systems.

  16. Integrating lifestyle approaches into osteoarthritis care

    Directory of Open Access Journals (Sweden)

    Garver MJ

    2015-09-01

    Full Text Available Matthew J Garver,1 Brian C Focht,2 Sarah J Taylor3 1Department of Kinesiology and Nutrition, Abilene Christian University, Abilene, TX, 2Department of Human Sciences, Ohio State University, Columbus, OH, 3School of Occupational Therapy, Texas Woman's University, Dallas, TX, USA Abstract: As the lifetime risk, societal cost, and overall functional impact of osteoarthritis (OA is imposing, it is imperative that clinicians provide an individualized care model for patients. Patients must be offered a multiplicity of care strategies and encouraged to embrace lifestyle approaches for self-managing the effects and symptoms of OA. Certainly, the attitude of the clinician and patient will directly influence receptivity and implementation of lifestyle approaches. This work proposes how the use of structured and routine assessments and cognitive therapy ideologies may complement a comprehensive treatment plan. Assessments described herein include objective and/or self-report measures of physical function, pain, attitude about social support, and sleep quality. Baseline assessments followed by systematic monitoring of the results may give patients and clinicians valuable insight into the effectiveness of the care plan. Empirical evidence from randomized trials with OA patients highlights the effectiveness of cognitive behavioral change strategies for addressing salient concerns for OA (pain control, mobility performance, and sleep quality. Cognitive restructuring can provide patients with renewed power in managing their disease. Cognitive therapy topics discussed presently include: 1 what is OA?, 2 effectiveness of exercise and FITT (frequency, intensity, time, and type principles for OA patients, 3 goal-setting and barriers, and 4 translating to independent care. Woven within the discussion about cognitive therapy are ideas about how the results from baseline assessments and group-mediated dynamics might assist more favorable outcomes. There are a plethora

  17. Integrated microsystems packaging approach with LCP

    Science.gov (United States)

    Jaynes, Paul; Shacklette, Lawrence W.

    2006-05-01

    Within the government communication market there is an increasing push to further miniaturize systems with the use of chip-scale packages, flip-chip bonding, and other advances over traditional packaging techniques. Harris' approach to miniaturization includes these traditional packaging advances, but goes beyond this level of miniaturization by combining the functional and structural elements of a system, thus creating a Multi-Functional Structural Circuit (MFSC). An emerging high-frequency, near hermetic, thermoplastic electronic substrate material, Liquid Crystal Polymer (LCP), is the material that will enable the combination of the electronic circuit and the physical structure of the system. The first embodiment of this vision for Harris is the development of a battlefield acoustic sensor module. This paper will introduce LCP and its advantages for MFSC, present an example of the work that Harris has performed, and speak to LCP MFSCs' potential benefits to miniature communications modules and sensor platforms.

  18. Integration of Medical Imaging Including Ultrasound into a New Clinical Anatomy Curriculum

    Science.gov (United States)

    Moscova, Michelle; Bryce, Deborah A.; Sindhusake, Doungkamol; Young, Noel

    2015-01-01

    In 2008 a new clinical anatomy curriculum with integrated medical imaging component was introduced into the University of Sydney Medical Program. Medical imaging used for teaching the new curriculum included normal radiography, MRI, CT scans, and ultrasound imaging. These techniques were incorporated into teaching over the first two years of the…

  19. Current Integration of Dissection in Medical Education in Australia and New Zealand: Challenges and Successes

    Science.gov (United States)

    Bouwer, Hope Ellen; Valter, Krisztina; Webb, Alexandra Louise

    2016-01-01

    The reduced use of dissection associated with the introduction of integrated systems problem-based learning curricula, graduate-entry programs and medical school expansion is a frequent topic of discussion and debate in modern medical training. The purpose of this study was to investigate the impact of these changes to the medical education…

  20. Learning about the Weather through an Integrated STEM Approach

    Science.gov (United States)

    Serin, Gokhan

    2014-01-01

    Introducing concepts through an integrated science, technology, engineering and mathematics (STEM) approach can promote interest and motivation (Bennett, Lubben and Hogarth, 2007; Bybee, 2010). However, implementing such an approach effectively in a classroom setting, with relevant links, is a challenging task. Some concepts lend themselves more…

  1. Integrated approach for the intensification of heterogeneous catalytic processes.

    Science.gov (United States)

    Kiwi-Minsker, Lioubov; Crespo-Quesada, Micaela

    2011-01-01

    The integrated approach for the design of solid catalysts for process intensification is presented addressing simultaneously different levels of scale and complexity involved in the development starting from the molecular/nano-scale of the active phase optimization up to the macro-scale of the catalytic reactor design. The feasibility of this approach is demonstrated through case studies carried out in our group.

  2. Numerical Approach to Calculation of Feynman Loop Integrals

    CERN Document Server

    Yuasa, F; Kurihara, Y; Fujimoto, J; Shimizu, Y; Hamaguchi, N; de Doncker, E; Kato, K

    2011-01-01

    In this paper, we describe a numerical approach to evaluate Feynman loop integrals. In this approach the key technique is a combination of a numerical integration method and a numerical extrapolation method. Since the computation is carried out in a fully numerical way, our approach is applicable to one-, two- and multi-loop diagrams. Without any analytic treatment it can compute diagrams with not only real masses but also complex masses for the internal particles. As concrete examples we present numerical results of a scalar one-loop box integral with complex masses and two-loop planar and non-planar box integrals with masses. We discuss the quality of our numerical computation by comparisons with other methods and also propose a self consistency check.

  3. How can Design Approaches be Integrated into Entrepreneurship Education?

    DEFF Research Database (Denmark)

    Færgemann, Helle Meibom; Nørgård, Rikke Toft; Robinson, Sarah

    Questions we care about: When educating students through entrepreneurship we are interested in how can design approaches and processes be integrated into Entrepreneurship Education and what effect does this have on entrepreneurial learning? Approach: This is a conceptual paper which draws on data...... testing. Value/Originality: This paper contributes to the field of entrepreneurship education with the model that demonstrates how design thinking can be meaningfully integrated into entrepreneurship education when pedagogical approaches are questioned and reflected upon....... analysed by scholars within both the design and entrepreneurship field to understand the potential of more fully integrating the design vocabulary and processes in entrepreneurship education. Results: Overall we see a lot of potential in integrating design elements into EE, if it is done with careful...

  4. MEDICAL MANAGEMENT OF DENTAL CARIES: A CHANGE IN THERAPEUTIC APPROACH

    Directory of Open Access Journals (Sweden)

    Amit Malhotra

    2013-01-01

    Full Text Available Dental caries is an infectious, communicable disease, which causes destruction of teeth by acid-forming bacteria found in dental plaque. Caries progression or reversal is determined by the balance between protective and pathological factors in the mouth. There have been revolutions in every field and dentistry is no exception to it, these changes have led to a change in concept from the conventional surgical approach of removing dental decay and cutting of tooth structure to the medical model which deals with interception of disease at different stages and possible reversal of the disease process. The key to medical paradigm is determination of caries risk in an individual and effective early detection of initial carious lesions. There are various equipments available in market which uses different principles for diagnosing caries susceptibility in an individual. In the years of thorough research different agents have been investigated for their role in caries prevention and reversal. There is a separate treatment plan for managing patients falling in different risk category. This article outlines the need for the medical management of dental caries and how it can be a viable option in dental decay management.

  5. Medical Researchers' Ancillary Care Obligations: The Relationship-Based Approach.

    Science.gov (United States)

    Olson, Nate W

    2016-06-01

    In this article, I provide a new account of the basis of medical researchers' ancillary care obligations. Ancillary care in medical research, or medical care that research participants need but that is not required for the validity or safety of a study or to redress research injuries, is a topic that has drawn increasing attention in research ethics over the last ten years. My view, the relationship-based approach, improves on the main existing theory, Richardson and Belsky's 'partial-entrustment model', by avoiding its problematic restriction on the scope of health needs for which researchers could be obligated to provide ancillary care. Instead, it grounds ancillary care obligations in a wide range of morally relevant features of the researcher-participant relationship, including the level of engagement between researchers and participants, and weighs these factors against each other. I argue that the level of engagement, that is, the duration and intensity of interactions, between researchers and participants matters for ancillary care because of its connection to the meaningfulness of a relationship, and I suggest that other morally relevant features can be grounded in researchers' role obligations.

  6. Integrating gross pathology into teaching of undergraduate medical science students using human cadavers.

    Science.gov (United States)

    Gopalan, Vinod; Dissabandara, Lakal; Nirthanan, Selvanayagam; Forwood, Mark R; Lam, Alfred King-Yin

    2016-09-01

    Human cadavers offer a great opportunity for histopathology students for the learning and teaching of tissue pathology. In this study, we aimed to implement an integrated learning approach by using cadavers to enhance students' knowledge and to develop their skills in gross tissue identification, handling and dissection techniques. A total of 35 students enrolled in the undergraduate medical science program participated in this study. A 3-hour laboratory session was conducted that included an active exploration of cadaveric specimens to identify normal and pathological tissues as well as tissue dissection. The majority of the students strongly agreed that the integration of normal and morbid anatomy improved their understanding of tissue pathology. All the students either agreed or strongly agreed that this laboratory session was useful to improve their tissue dissection and instrument handling skills. Furthermore, students from both cohorts rated the session as very relevant to their learning and recommended that this approach be added to the existing histopathology curriculum. To conclude, an integrated cadaver-based practical session can be used effectively to enhance the learning experience of histopathology science students, as well as improving their manual skills of tissue treatment, instrument handling and dissection.

  7. Integrated approach in fluidized bed combustion

    Energy Technology Data Exchange (ETDEWEB)

    Bruyet, B.; Gautrin, M. [CERCHAR, Mazingarbe (France)

    1998-12-31

    Atmospheric fluidized bed technology for combustion is frequently found in different advanced power and steam generation systems, because the fluidization provides operating conditions which are favourable for pollutant control and also offers the possibility to utilise a wide range of fuels. The main objective of the study was to contribute to the development of a methodology for an easier global approach of the implementation of atmospheric fluidized bed reactors and upstream elements associated with taking into account the characteristics of fuels and sorbents, the requirements on gaseous pollutants and on solid by-products utilisation. Previous tests done in CERCHAR`s facilities were scrutinised, additional tests at laboratory and pilot level were carried out, some industrial plants were considered. Several fuels were considered (brown coals, coals, slurry,...), with a special attention to Gottelborn reference coal and Rheinbraun lignite. Experimental results and tentative conclusions viz. fuel characterization, batch fluidization set-up, 1 MW atmospheric fluidized bed pilot, ash utilisation/disposal, methodology and management of preliminary testing are presented. 12 refs., 18 figs., 13 tabs.

  8. An integral approach to investigate planetary cores

    Science.gov (United States)

    Fei, Y.

    2012-12-01

    shockwave compression to determine density, sound velocity, and melting of core materials up to liquid outer core conditions. The integration of the static and dynamic compression data provides an extensive dataset over a wide pressure and temperature range that is necessary for establishing a comprehensive model of the planetary cores, providing the best fit to the geophysical, cosmochemial, and geochemical observations.

  9. Enabling Medical Device Interoperability for the Integrated Clinical Environment

    Science.gov (United States)

    2016-02-01

    Real-Time Blue Button for Patients and Families ,” that streams physiological data (including waveforms) from medical devices connected at our lab in...Interoperability Showcase at HIMSS14, we demonstrated a new ICE app, “Real-Time Blue Button for Patients and Families ,” that streams physiological data (including...waveforms) from medical devices connected at our lab in Cambridge, MA, as well as data from medical devices connected locally. At the SmartAmerica

  10. Religiously Integrated Cognitive Behavioral Therapy: A New Method of Treatment for Major Depression in Patients With Chronic Medical Illness

    Science.gov (United States)

    Pearce, Michelle J.; Koenig, Harold G.; Robins, Clive J.; Nelson, Bruce; Shaw, Sally F.; Cohen, Harvey J.; King, Michael B.

    2015-01-01

    Intervention studies have found that psychotherapeutic interventions that explicitly integrate clients’ spiritual and religious beliefs in therapy are as effective, if not more so, in reducing depression than those that do not for religious clients. However, few empirical studies have examined the effectiveness of religiously (vs. spiritually) integrated psychotherapy, and no manualized mental health intervention had been developed for the medically ill with religious beliefs. To address this gap, we developed and implemented a novel religiously integrated adaptation of cognitive–behavioral therapy (CBT) for the treatment of depression in individuals with chronic medical illness. This article describes the development and implementation of the intervention. First, we provide a brief overview of CBT. Next, we describe how religious beliefs and behaviors can be integrated into a CBT framework. Finally, we describe Religiously Integrated Cognitive Behavioral Therapy (RCBT), a manualized therapeutic approach designed to assist depressed individuals to develop depression-reducing thoughts and behaviors informed by their own religious beliefs, practices, and resources. This treatment approach has been developed for 5 major world religions (Christianity, Judaism, Islam, Buddhism, and Hinduism), increasing its potential to aid the depressed medically ill from a variety of religious backgrounds. PMID:25365155

  11. An Integrated Management Approach to Atrial Fibrillation.

    Science.gov (United States)

    Carter, Lindsey; Gardner, Martin; Magee, Kirk; Fearon, Ann; Morgulis, Inna; Doucette, Steve; Sapp, John L; Gray, Chris; Abdelwahab, Amir; Parkash, Ratika

    2016-01-25

    Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia resulting in mortality and morbidity. Gaps in oral anticoagulation and education of patients regarding AF have been identified as areas that require improvement. A before-and-after study of 433 patients with newly diagnosed AF in the 3 emergency departments in Nova Scotia from January 1, 2011 until January 31, 2014 was performed. The "before" phase underwent the usual-care pathway for AF management; the "after" phase was enrolled in a nurse-run, physician-supervised AF clinic. The primary outcome was a composite of death, cardiovascular hospitalization, and AF-related emergency department visits. A propensity analysis was performed to account for differences in baseline characteristics. A total of 185 patients were enrolled into the usual-care group, and 228 patients were enrolled in the AF clinic group. The mean age was 64±15 years and 44% were women. In a propensity-matched analysis, the primary outcome occurred in 44 (26.2%) patients in the usual-care group and 29 (17.3%) patients in the AF clinic group (odds ratio 0.71; 95% CI [0.59, 1]; P=0.049) at 12 months. Prescription of oral anticoagulation was increased in the CHADS2 ≥2 group (88.4% in the AF clinic versus 58.5% in the usual-care group, Pmanagement approach for the burgeoning population of AF may provide an overall benefit to cardiovascular morbidity and mortality. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  12. Care concept in medical and nursing students’ descriptions – Philosophical approach and implications for medical education

    Directory of Open Access Journals (Sweden)

    Beata Dobrowolska

    2014-11-01

    Full Text Available [b]introduction.[/b] Care is seen as something that is peculiar to the medical sciences but its meaning and status for physicians and nurses differs. objectives. The aim of this research was to learn how nursing and medical students understand and define care, and how their definition and views on their practice of caring change as they advance through their studies. [b]material and methods[/b]. The study was conducted among two groups of students: before and after their first practicum (n=102. Analysis of the students’ answers was carried out using Colaizzi’s phenomenological descriptive methodology, which means that a qualitative approach was used. [b]results[/b]. The qualitative analysis shows that the medical and nursing students define care in the same way, using 9 main categories: compassion, commitment, competence, confidence, conscience, communication, patience, courage and support. The nursing students viewed their caring to be within both practical and emotional dimensions and this was a core feature of their identity as nurses. Medical students, on the other hand, viewed the practical dimension of care as an additional activity. All the students in the study underlined the importance of having time to care and showed that, for them, ‘time’ in this context has a moral meaning. What was interesting to the research team centered on the initial attitudes to ‘caring’ from both medical and nursing students. [b]conclusions[/b]. We found that students of both nursing and medicine do not begin their studies with different attitudes and concepts of care. However, after their initial exposure to practical placements a process begins which forges different identities around the concept of care. This implies trends in the division of professional roles during their initial education.

  13. Efifcient Methods for Approaching Functional Safety to Hardware Systems of Medical Devices

    Institute of Scientific and Technical Information of China (English)

    KIMGi-young; WANGDa-wei; PARKHo-joon; JANG Joong-soon

    2015-01-01

    A medical device is an instrument that includes components, parts, or accessories to diagnose or treat patients. Since the complexity of medical devices has increased in recent years, functional safety and basic safety are required to ensure the overall device safety. Functional safety is part of the overall safety that relates to the equipment under control (EUC) and to the EUC control system that depends on the correct functionality of the electrical/electronic/programmable electronic (E/E/PE) safety-related systems. This study proposes approach methods to functional safety of medical devices for which it is important to correctly identify the safety functions and the safety integrity level (SIL). The relationship between the functional safety and essential performance is identiifed focusing on the safety function. The essential performance of E/E/PE systems is deifned as the safety function of the functional safety. The target SIL of the essential performance is determined according to the potential risk levels, based on the classiifcation rules of medical devices. This approach is applied to the pulse oximeter as a case study. The target SIL for the functionality of the power-failure alarm condition is determined to be SIL1. The target SILs of other functions are determined as SIL2.

  14. Advancing medical education: connecting interprofessional collaboration and education opportunities with integrative medicine initiatives to build shared learning.

    Science.gov (United States)

    Templeman, Kate; Robinson, Anske; McKenna, Lisa

    2016-12-01

    BackgroundImproved teamwork between conventional and complementary medicine (CM) practitioners is indicated to achieve effective healthcare. However, little is known about interprofessional collaboration and education in the context of integrative medicine (IM). MethodsThis paper reports the findings from a constructivist-grounded theory method study that explored and highlighted Australian medical students' experiences and opportunities for linking interprofessional collaboration and learning in the context of IM. Following ethical approval, in-depth semi-structured interviews were conducted with 30 medical students from 10 medical education faculties across Australian universities. Results Medical students recognised the importance of interprofessional teamwork between general medical practitioners and CM professionals in patient care and described perspectives of shared responsibilities, profession-specific responsibilities, and collaborative approaches within IM. While students identified that limited interprofessional collaboration currently occurred in the medical curriculum, interprofessional education was considered a means of increasing communication and collaboration between healthcare professionals, helping coordinate effective patient care, and understanding each healthcare team members' professional role and value. Conclusions The findings suggest that medical curricula should include opportunities for medical students to develop required skills, behaviours, and attitudes for interprofessional collaboration and interprofessional education within the context of IM. While this is a qualitative study that reflects theoretical saturation from a selected cohort of medical students, the results also point to the importance of including CM professionals within interprofessional collaboration, thus contributing to more person-centred care.

  15. Personality and Medical Specialty Choice: A Literature Review and Integration.

    Science.gov (United States)

    Borges, Nicole J.; Savickas, Mark L.

    2002-01-01

    Synthesizes studies categorized by medical specialties and using the following instruments into the Five Factor Model of personality: Adjective Check List, California Psychological Inventory, 16 Personality Factor Questionnaire, and Myers-Briggs Type Indicator. Suggests a loose association between personalty factors and medical specialties and…

  16. Anatomy as the Backbone of an Integrated First Year Medical Curriculum: Design and Implementation

    Science.gov (United States)

    Klement, Brenda J.; Paulsen, Douglas F.; Wineski, Lawrence E.

    2011-01-01

    Morehouse School of Medicine chose to restructure its first year medical curriculum in 2005. The anatomy faculty had prior experience in integrating courses, stemming from the successful integration of individual anatomical sciences courses into a single course called Human Morphology. The integration process was expanded to include the other…

  17. Anatomy as the Backbone of an Integrated First Year Medical Curriculum: Design and Implementation

    Science.gov (United States)

    Klement, Brenda J.; Paulsen, Douglas F.; Wineski, Lawrence E.

    2011-01-01

    Morehouse School of Medicine chose to restructure its first year medical curriculum in 2005. The anatomy faculty had prior experience in integrating courses, stemming from the successful integration of individual anatomical sciences courses into a single course called Human Morphology. The integration process was expanded to include the other…

  18. Molecular medicine; the road to the better integration of the medical sciences in the twenty-first century.

    Science.gov (United States)

    Weatherall, D J

    2010-09-20

    The history of the evolution of medical research is characterized by a long period of division between the basic biological sciences and the health sciences, reflecting the seventeenth-century trends towards the experimental and the empirical. It was not until the middle of the twentieth century that, by their ability to straddle both worlds, the work of small groups of basic scientists in the U.S.A. and Europe led to closer integration between the medical sciences. This change in direction is well exemplified by the work of the Cambridge scientists Max Perutz, Vernon Ingram and Herman Lehmann, from 1950 onwards. Their research, and its later development by others, was to lay the basis for what became known as 'molecular medicine', and at the same time set the scene for a more integrated approach to medical research that continued into the new millennium.

  19. Integrating complementary medicine literacy education into Australian medical curricula: Student-identified techniques and strategies for implementation.

    Science.gov (United States)

    Templeman, Kate; Robinson, Anske; McKenna, Lisa

    2015-11-01

    Formal medical education about complementary medicine (CM) that comprises medicinal products/treatments is required due to possible CM interactions with conventional medicines; however, few guidelines exist on design and implementation of such education. This paper reports findings of a constructivist grounded theory method study that identified key strategies for integrating CM literacy education into medical curricula. Analysis of data from interviews with 30 medical students showed that students supported a longitudinal integrative and pluralistic approach to medicine. Awareness of common patient use, evidence, and information relevant to future clinical practice were identified as focus points needed for CM literacy education. Students advocated for interactive case-based, experiential and dialogical didactic techniques that are multiprofessional and student-centred. Suggested strategies provide key elements of CM literacy within research, field-based practice, and didactic teaching over the entirety of the curriculum. CM educational strategies should address CM knowledge deficits and ultimately respond to patients' needs.

  20. Towards an integrated approach to marine benthic monitoring.

    Science.gov (United States)

    Barrio Froján, Christopher R S; Cooper, Keith M; Bolam, Stefan G

    2016-03-15

    In the UK, most marine benthic monitoring is carried out in a piecemeal fashion, funded by different sectors of industry that utilise the marine environment under licence. Monitoring requirements are imposed by licence conditions, which can vary considerably between licences. The UK Government also conducts marine environmental surveys in support of its legislative commitments. The present investigation reviews these different monitoring approaches to highlight whether synergies between them could be developed into an integrated approach to marine benthic monitoring. An integrated approach would have ecological benefits, as greater consistency in sampling and analytical protocols would reduce uncertainty in the predictions of impact, and facilitate the assessment of Good Environmental Status under the Marine Strategy Framework Directive. The same approach would also be of financial benefit, as spatio-temporal duplication in sampling would be reduced, and the value of acquired data would be maximised, resulting in a more efficient and cost-effective approach.

  1. Influence of a veterinary curriculum on the approaches and study skills of veterinary medical students.

    Science.gov (United States)

    Chigerwe, Munashe; Ilkiw, Jan E; Boudreaux, Karen A

    2011-01-01

    The objectives of the present study were to evaluate first-, second-, third-, and fourth-year veterinary medical students' approaches to studying and learning as well as the factors within the curriculum that may influence these approaches. A questionnaire consisting of the short version of the Approaches and Study Skills Inventory for Students (ASSIST) was completed by 405 students, and it included questions relating to conceptions about learning, approaches to studying, and preferences for different types of courses and teaching. Descriptive statistics, factor analysis, Cronbach's alpha analysis, and log-linear analysis were performed on the data. Deep, strategic, and surface learning approaches emerged. There were a few differences between our findings and those presented in previous studies in terms of the correlation of the subscale monitoring effectiveness, which showed loading with both the deep and strategic learning approaches. In addition, the subscale alertness to assessment demands showed correlation with the surface learning approach. The perception of high workloads, the use of previous test files as a method for studying, and examinations that are based only on material provided in lecture notes were positively associated with the surface learning approach. Focusing on improving specific teaching and assessment methods that enhance deep learning is anticipated to enhance students' positive learning experience. These teaching methods include instructors who encourage students to be critical thinkers, the integration of course material in other disciplines, courses that encourage thinking and reading about the learning material, and books and articles that challenge students while providing explanations beyond lecture material.

  2. Postgraduate medical education: rethinking and integrating a complex landscape.

    Science.gov (United States)

    Dowton, S Bruce; Stokes, Marie-Louise; Rawstron, Evan J; Pogson, Philip R; Brown, Mark A

    2005-02-21

    A key responsibility of the healthcare system is to develop a sustainable workforce through education and training. The complexity of postgraduate medical education and training in Australia requires: recognition that there are many stakeholders (junior medical officers, registrars, teaching clinicians, health departments, governments, colleges and society) with overlapping but competing interests and responsibilities; a national dialogue to clarify the necessary resource investments and to assign explicit accountabilities; and improved coordination and governance, while maintaining appropriate flexibility. In other countries, stronger mechanisms of governance for oversight of postgraduate medical education have emerged, and Australia can learn from these.

  3. The Pentabox Master Integrals with the Simplified Differential Equations approach

    CERN Document Server

    Papadopoulos, Costas G; Wever, Christopher

    2015-01-01

    We present the calculation of massless two-loop Master Integrals relevant to five-point amplitudes with one off-shell external leg and derive the complete set of planar Master Integrals with five on-mass-shell legs, that contribute to many $2\\to 3$ amplitudes of interest at the LHC, as for instance three jet production, $\\gamma, V, H +2$ jets etc., based on the Simplified Differential Equations approach.

  4. Views on group simulation in an integrated medical curriculum

    OpenAIRE

    Salaria M; Oyewole T; Shah S

    2017-01-01

    Mariam Salaria, Tobi Oyewole, Sundes ShahUniversity of Liverpool, School of Medicine, Liverpool, UKWe read with great interest the article by Ginzburg et al,1 regarding small group simulation with debrief, for first and second year medical students. Having completed four years at Liverpool Medical School, we agree that small group simulation assists in consolidating the knowledge of basic sciences. The article states that the majority of students agree that simulation followed by a debrief, i...

  5. Integrated Transport Planning Framework Involving Combined Utility Regret Approach

    DEFF Research Database (Denmark)

    Wang, Yang; Monzon, Andres; Di Ciommo, Floridea;

    2014-01-01

    Sustainable transport planning requires an integrated approach involving strategic planning, impact analysis, and multicriteria evaluation. This study aimed at relaxing the utility-based decision-making assumption by newly embedding anticipated-regret and combined utility regret decision mechanisms...... in a framework for integrated transport planning. The framework consisted of a two-round Delphi survey, integrated land use and transport model for Madrid, and multicriteria analysis. Results show that (a) the regret-based ranking has a similar mean but larger variance than the utility-based ranking does, (b...

  6. An Integrated Approach for Entry Mission Design and Flight Simulations

    Science.gov (United States)

    Lu, Ping; Rao, Prabhakara

    2004-01-01

    An integrated approach for entry trajectory design, guidance, and simulation is proposed. The key ingredients for this approach are an on-line 3 degree-of-freedom entry trajectory planning algorithm and the entry guidance algorithm that generates the guidance gains automatically. When fully developed, such a tool could enable end-bend entry mission design and simulations in 3DOF and 6DOF mode from de-orbit burn to the TAEM interface and beyond, all in one key stroke. Some preliminary examples of such a capability are presented in this paper that demonstrate the potential of this type of integrated environment.

  7. An integrated lean-methods approach to hospital facilities redesign.

    Science.gov (United States)

    Nicholas, John

    2012-01-01

    Lean production methods for eliminating waste and improving processes in manufacturing are now being applied in healthcare. As the author shows, the methods are appropriate for redesigning hospital facilities. When used in an integrated manner and employing teams of mostly clinicians, the methods produce facility designs that are custom-fit to patient needs and caregiver work processes, and reduce operational costs. The author reviews lean methods and an approach for integrating them in the redesign of hospital facilities. A case example of the redesign of an emergency department shows the feasibility and benefits of the approach.

  8. Toward integrated laser-driven ion accelerator systems at the photo-medical research center in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Bolton, P.R., E-mail: bolton.paul@jaea.go.j [Photo-Medical Research Center, Japan Atomic Energy Agency, 8-1-7 Umemidai Kizugawa-shi, Kyoto 619-0215 (Japan); Hori, T.; Kiriyama, H.; Mori, M.; Sakaki, H. [Photo-Medical Research Center, Japan Atomic Energy Agency, 8-1-7 Umemidai Kizugawa-shi, Kyoto 619-0215 (Japan); Sutherland, K. [Hokkaido University, School of Medicine, Sapporo-shi, Kita-ku, Kita 12 Jo, Nishi 5 Chome 060-0812 (Japan); Suzuki, M. [Photo-Medical Research Center, Japan Atomic Energy Agency, 8-1-7 Umemidai Kizugawa-shi, Kyoto 619-0215 (Japan); Wu, J. [SLAC National Accelerator Laboratory, Stanford University, Menlo Park, CA (United States); Yogo, A. [Photo-Medical Research Center, Japan Atomic Energy Agency, 8-1-7 Umemidai Kizugawa-shi, Kyoto 619-0215 (Japan)

    2010-08-01

    Goals and early progress at the Photo-Medical Research Center are summarized. Laser-driven ion beam radiotherapy can require compact repetition-rated laser systems with peak powers approaching the PW level. Laser development at PMRC is outlined. Our parallel experimental and simulation efforts aimed at the development of a prototype ion beamline as an integrated laser-driven ion accelerator system are presented. In addition some of our first medical and radiobiological experimental investigations, proton-induced double strand breaking in human cancer cells and simulations of optimum dose distributions for ocular melanoma are discussed. Recommended components of a balanced and comprehensive PMRC agenda are given.

  9. Curricular integration of social medicine: a prospective for medical educators.

    Science.gov (United States)

    Vanderbilt, Allison A; Baugh, Reginald F; Hogue, Patricia A; Brennan, Julie A; Ali, Imran I

    2016-01-01

    In the United States, the health of a community falls on a continuum ranging from healthy to unhealthy and fluctuates based on several variables. Research policy and public health practice literature report substantial disparities in life expectancy, morbidity, risk factors, and quality of life, as well as persistence of these disparities among segments of the population. One such way to close this gap is to streamline medical education to better prepare our future physicians for our patients in underserved communities. Medical schools have the potential to close the gap when training future physicians by providing them with the principles of social medicine that can contribute to the reduction of health disparities. Curriculum reform and systematic formative assessment and evaluative measures can be developed to match social medicine and health disparities curricula for individual medical schools, thus assuring that future physicians are being properly prepared for residency and the workforce to decrease health inequities in the United States. We propose that curriculum reform includes an ongoing social medicine component for medical students. Continued exposure, practice, and education related to social medicine across medical school will enhance the awareness and knowledge for our students. This will result in better preparation for the zero mile stone residency set forth by the Accreditation Council of Graduate Medical Education and will eventually lead to the outcome of higher quality physicians in the United States to treat diverse populations.

  10. Tackling burden in ART: an integrated approach for medical staff

    NARCIS (Netherlands)

    Boivin, J.; Domar, A.D.; Shapiro, D.B.; Wischmann, T.H.; Fauser, B.C.J.M.; Verhaak, C.M.

    2012-01-01

    Discontinuation is a problem in fertility clinics. Many couples discontinue assisted reproductive technologies (ART) without achieving a live birth for reasons other than poor prognosis or the cost of treatment. Discontinuation has been attributed to the burden of treatment. The causes of burden can

  11. Tackling burden in ART: an integrated approach for medical staff

    NARCIS (Netherlands)

    Boivin, J.; Domar, A.D.; Shapiro, D.B.; Wischmann, T.H.; Fauser, B.C.J.M.; Verhaak, C.M.

    2012-01-01

    Discontinuation is a problem in fertility clinics. Many couples discontinue assisted reproductive technologies (ART) without achieving a live birth for reasons other than poor prognosis or the cost of treatment. Discontinuation has been attributed to the burden of treatment. The causes of burden can

  12. An Integrated Approach for Creating Service-Based Interactive Applications

    Science.gov (United States)

    Feldmann, Marius; Janeiro, Jordan; Nestler, Tobias; Hübsch, Gerald; Jugel, Uwe; Preussner, André; Schill, Alexander

    While the implementation of business logic and business processes based on service-oriented architectures is well-understood and covered by existing development approaches, integrated concepts that empower users to exploit the Internet of Services to create complex interactive applications are missing. In this paper, we present an integrated approach that fills this gap. Our approach builds upon service annotations that add meta-information related to user interface generation, service dependencies, and service composition to existing service descriptions. Services can be composed visually to complex interactive applications based on these annotations without the need to write any code. The application code is generated completely from the service composition description. Our approach is able to support heterogeneous target environments ranging from client/server architectures to mobile platforms.

  13. Academic medicine amenities unit: developing a model to integrate academic medical care with luxury hotel services.

    Science.gov (United States)

    Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R

    2009-02-01

    The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.

  14. Integration of Cognitive Skills as a Cross-Cutting Theme Into the Undergraduate Medical Curriculum at Tehran University of Medical Sciences.

    Science.gov (United States)

    Soltani, Akbar; Allaa, Maryam; Moosapour, Hamideh; Aletaha, Azadeh; Shahrtash, Farzaneh; Monajemi, Alireza; Arastoo, Tohid; Ahmadinejad, Maryam; Mirzazadeh, Azim; Khabaz Mafinejad, Mahboobeh

    2017-01-01

    Nowadays, improvement of thinking skills of students is one of the universally supported aims in the majority of medical schools. This study aims to design longitudinal theme of reasoning, problem-solving and decision-making into the undergraduate medical curriculum at Tehran University of Medical Sciences (TUMS). A participatory approach was applied to design the curriculum during 2009-2011. The project was conducted by the contribution of representatives of both basic and clinical faculty members, students and graduates at Tehran University of Medical Sciences. The first step toward integrating cognitive skills into the curriculum was to assemble a taskforce of different faculty and students, including a wide variety of fields with multidisciplinary expertise using nonprobability sampling and the snowball method. Several meetings with the contribution of experts and some medical students were held to generate the draft of expected outcomes. Subsequently, the taskforce also determined what content would fit best into each phase of the program and what teaching and assessment methods would be more appropriate for each outcome. After a pilot curriculum with a small group of second-year medical students, we implemented this program for all first-year students since 2011 at TUMS. Based on findings, the teaching of four areas, including scientific and critical thinking skills (Basic sciences), problem-solving and reasoning (Pathophysiology), evidence-based medicine (Clerkship), and clinical decision-making (Internship) were considered in the form of a longitudinal theme. The results of this study could be utilized as a useful pattern for integration of psycho-social subjects into the medical curriculum.

  15. Influence of national culture on the adoption of integrated medical curricula.

    Science.gov (United States)

    Jippes, Mariëlle; Majoor, Gerard D

    2011-03-01

    Integrated curricula have been implemented in medical schools all over the world. However, among countries different relative numbers of schools with integrated curricula are found. This study aims to explore the possible correlation between the percentage of medical schools with integrated curricula in a country and that country's cultural characteristics. Curricula were defined as not integrated if in the first 2 years of the program at least two out of the three monodisciplinary courses Anatomy, Physiology and Biochemistry were identified. Culture was defined using Hofstede's dimensions Power distance, Uncertainty avoidance, Masculinity/Femininity, and Individualism/Collectivism. Consequently, this study had to be restricted to the 63 countries included in Hofstede's studies which harbored 1,195 medical schools. From each country we randomly sampled a maximum of 15 schools yielding 484 schools to be investigated. In total 91% (446) of the curricula were found. Correlation of percent integrated curricula and each dimension of culture was determined by calculating Spearman's Rho. A high score on the Power distance index and a high score on the Uncertainty avoidance index correlated with a low percent integrated curricula; a high score on the Individualism index correlated with a high percent integrated curricula. The percentage integrated curricula in a country did not correlate with its score on the Masculinity index. National culture is associated with the propensity of medical schools to adopt integrated medical curricula. Consequently, medical schools considering introduction of integrated and problem-based medical curricula should take into account dimensions of national culture which may hinder the innovation process.

  16. Toward the Integration of Traditional and Agile Approaches

    Directory of Open Access Journals (Sweden)

    Hung-Fu Chang

    2013-03-01

    Full Text Available The agile approach uses continuous delivery, instead of distinct procedure, to work closer with customers and to respond faster requirement changes. All of these are against the traditional plan driven approach. Due to agile method’s characteristics and its success in the real world practices, a number of discussions regarding the differences between agile and traditional approaches emerged recently and many studies intended to integrate both methods to synthesize the benefits from these two sides. However, this type of research often concludes from observations of a development activity or surveys after a project. To provide a more objective supportive evidence of comparing these two approaches, our research analyzes the source codes, logs, and notes. We argue that the agile and traditional approaches share common characteristics, which can be considered as the glue for integrating both methods. In our study, we collect all the submissions from the version control repository, and meeting notes and discussions. By applying our suggested analysis method, we illustrate the shared properties between agile and traditional approaches; thus, different development phases, like implementation and test, can still be identified in agile development history. This result not only provides a positive result for our hypothesis but also offers a suggestion for a better integration.

  17. Building Safer Communities: The Integrated Community Safety Approach

    Energy Technology Data Exchange (ETDEWEB)

    Fawcett, Ricky Lee; Kerr, Thomas A; Jordan, Steven Albert

    2001-03-01

    This paper discusses an integrated community safety approach to creating safer communities. It defines community broadly to include two categories of community members: “industry” and “neighbors.” Potential community members within the “industry” category include facilities, government/regulators, customers, stockholders, and suppliers. Within the “neighbors” category are towns, cities, counties, states; people/commodity flow systems; news media and special interest groups; environment; and families of employees. Each of these potential community members and its characteristics are discussed. The integrated community safety approach consists of three major activities: (1) define the boundaries of the community; (2) facilitate the sense of community; and (3) address the needs of the community. Defining the boundaries of the community includes determining the geographical and social boundaries; this is accomplished through conducting a hazard analysis and community involvement to identify all of the community members. Facilitating the sense of community includes conducting a capability/needs assessment and continuing community involvement to identify the issues and concerns of community members. Addressing the needs of the community involves master planning to consider safety issues in all community development actions and continuing community education and involvement. The integrated community safety approach is a workable approach for existing industries and their neighbors as well as new projects that industries and their neighbors might be considering. By using this socio-technical approach to integrating industry and all of its neighbors into a safer community, the integrated community safety approach will better assure the viability and safety of industry and its neighbors while maintaining or improving the overall quality of life.

  18. Calculation of plantar pressure time integral, an alternative approach.

    Science.gov (United States)

    Melai, Tom; IJzerman, T Herman; Schaper, Nicolaas C; de Lange, Ton L H; Willems, Paul J B; Meijer, Kenneth; Lieverse, Aloysius G; Savelberg, Hans H C M

    2011-07-01

    In plantar pressure measurement, both peak pressure and pressure time integral are used as variables to assess plantar loading. However, pressure time integral shows a high concordance with peak pressure. Many researchers and clinicians use Novel software (Novel GmbH Inc., Munich, Germany) that calculates this variable as the summation of the products of peak pressure and duration per time sample, which is not a genuine integral of pressure over time. Therefore, an alternative calculation method was introduced. The aim of this study was to explore the relevance of this alternative method, in different populations. Plantar pressure variables were measured in 76 people with diabetic polyneuropathy, 33 diabetic controls without polyneuropathy and 19 healthy subjects. Peak pressure and pressure time integral were obtained using Novel software. The quotient of the genuine force time integral over contact area was obtained as the alternative pressure time integral calculation. This new alternative method correlated less with peak pressure than the pressure time integral as calculated by Novel. The two methods differed significantly and these differences varied between the foot sole areas and between groups. The largest differences were found under the metatarsal heads in the group with diabetic polyneuropathy. From a theoretical perspective, the alternative approach provides a more valid calculation of the pressure time integral. In addition, this study showed that the alternative calculation is of added value, along peak pressure calculation, to interpret adapted plantar pressures patterns in particular in patients at risk for foot ulceration. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. Program evaluation of an Integrated Basic Science Medical Curriculum in Shiraz Medical School, Using CIPP Evaluation Model.

    Science.gov (United States)

    Rooholamini, Azadeh; Amini, Mitra; Bazrafkan, Leila; Dehghani, Mohammad Reza; Esmaeilzadeh, Zohreh; Nabeiei, Parisa; Rezaee, Rita; Kojuri, Javad

    2017-07-01

    In recent years curriculum reform and integration was done in many medical schools. The integrated curriculum is a popular concept all over the world. In Shiraz medical school, the reform was initiated by stablishing the horizontal basic science integration model and Early Clinical Exposure (ECE) for undergraduate medical education. The purpose of this study was to provide the required data for the program evaluation of this curriculum for undergraduate medical students, using CIPP program evaluation model. This study is an analytic descriptive and triangulation mixed method study which was carried out in Shiraz Medical School in 2012, based on the views of professors of basic sciences courses and first and second year medical students. The study evaluated the quality of the relationship between basic sciences and clinical courses and the method of presenting such courses based on the Context, Input, Process and Product (CIPP) model. The tools for collecting data, both quantitatively and qualitatively, were some questionnaires, content analysis of portfolios, semi- structured interview and brain storming sessions. For quantitative data analysis, SPSS software, version 14, was used. In the context evaluation by modified DREEM questionnaire, 77.75%of the students believed that this educational system encourages them to actively participate in classes. Course schedule and atmosphere of class were reported suitable by 87.81% and 83.86% of students. In input domain that was measured by a researcher made questionnaire, the facilities for education were acceptable except for shortage of cadavers. In process evaluation, the quality of integrated modules presentation and Early Clinical Exposure (ECE) was good from the students' viewpoint. In product evaluation, students' brain storming, students' portfolio and semi-structured interview with faculties were done, showing some positive aspects of integration and some areas that need improvement. The main advantage of assessing

  20. Motivating medical students to learn basic science concepts using chronic myeloid leukemia as an integration theme

    Directory of Open Access Journals (Sweden)

    Sara Teresinha Olalla Saad

    2015-02-01

    Full Text Available Objective: To report on the use of chronic myeloid leukemia as a theme of basic clinical integration for first year medical students to motivate and enable in-depth understanding of the basic sciences of the future physician. Methods: During the past thirteen years we have reviewed and updated the curriculum of the medical school of the Universidade Estadual de Campinas. The main objective of the new curriculum is to teach the students how to learn to learn. Since then, a case of chronic myeloid leukemia has been introduced to first year medical students and discussed in horizontal integration with all themes taught during a molecular and cell biology course. Cell structure and components, protein, chromosomes, gene organization, proliferation, cell cycle, apoptosis, signaling and so on are all themes approached during this course. At the end of every topic approached, the students prepare in advance the corresponding topic of clinical cases chosen randomly during the class, which are then presented by them. During the final class, a paper regarding mutations in the abl gene that cause resistance to tyrosine kinase inhibitors is discussed. After each class, three tests are solved in an interactive evaluation. Results: The course has been successful since its beginning, 13 years ago. Great motivation of those who participated in the course was observed. There were less than 20% absences in the classes. At least three (and as many as nine students every year were interested in starting research training in the field of hematology. At the end of each class, an interactive evaluation was performed and more than 70% of the answers were correct in each evaluation. Moreover, for the final evaluation, the students summarized, in a written report, the molecular and therapeutic basis of chronic myeloid leukemia, with scores ranging from 0 to 10. Considering all 13 years, a median of 78% of the class scored above 5 (min 74%-max 85%, and a median of 67

  1. Bayesian Analysis for Risk Assessment of Selected Medical Events in Support of the Integrated Medical Model Effort

    Science.gov (United States)

    Gilkey, Kelly M.; Myers, Jerry G.; McRae, Michael P.; Griffin, Elise A.; Kallrui, Aditya S.

    2012-01-01

    The Exploration Medical Capability project is creating a catalog of risk assessments using the Integrated Medical Model (IMM). The IMM is a software-based system intended to assist mission planners in preparing for spaceflight missions by helping them to make informed decisions about medical preparations and supplies needed for combating and treating various medical events using Probabilistic Risk Assessment. The objective is to use statistical analyses to inform the IMM decision tool with estimated probabilities of medical events occurring during an exploration mission. Because data regarding astronaut health are limited, Bayesian statistical analysis is used. Bayesian inference combines prior knowledge, such as data from the general U.S. population, the U.S. Submarine Force, or the analog astronaut population located at the NASA Johnson Space Center, with observed data for the medical condition of interest. The posterior results reflect the best evidence for specific medical events occurring in flight. Bayes theorem provides a formal mechanism for combining available observed data with data from similar studies to support the quantification process. The IMM team performed Bayesian updates on the following medical events: angina, appendicitis, atrial fibrillation, atrial flutter, dental abscess, dental caries, dental periodontal disease, gallstone disease, herpes zoster, renal stones, seizure, and stroke.

  2. Views on group simulation in an integrated medical curriculum

    Directory of Open Access Journals (Sweden)

    Salaria M

    2017-03-01

    Full Text Available Mariam Salaria, Tobi Oyewole, Sundes ShahUniversity of Liverpool, School of Medicine, Liverpool, UKWe read with great interest the article by Ginzburg et al,1 regarding small group simulation with debrief, for first and second year medical students. Having completed four years at Liverpool Medical School, we agree that small group simulation assists in consolidating the knowledge of basic sciences. The article states that the majority of students agree that simulation followed by a debrief, illustrated the clinical relevance of basic sciences. What is more, students felt that these practices provided chances for direct application of scientific knowledge, as well as simulating real world experience. The development of clinical reasoning was also noted, and as medical students ourselves, we agree that this aspect is cemented by simulation scenarios.View the original paper by Ginzburg and colleagues.

  3. An integrated medical image database and retrieval system using a web application server.

    Science.gov (United States)

    Cao, Pengyu; Hashiba, Masao; Akazawa, Kouhei; Yamakawa, Tomoko; Matsuto, Takayuki

    2003-08-01

    We developed an Integrated Medical Image Database and Retrieval System (INIS) for easy access by medical staff. The INIS mainly consisted of four parts: specific servers to save medical images from multi-vendor modalities of CT, MRI, CR, ECG and endoscopy; an integrated image database (DB) server to save various kinds of images in a DICOM format; a Web application server to connect clients to the integrated image DB and the Web browser terminals connected to an HIS system. The INIS provided a common screen design to retrieve CT, MRI, CR, endoscopic and ECG images, and radiological reports, which would allow doctors to retrieve radiological images and corresponding reports, or ECG images of a patient simultaneously on a screen. Doctors working in internal medicine on average accessed information 492 times a month. Doctors working in cardiological and gastroenterological accessed information 308 times a month. Using the INIS, medical staff could browse all or parts of a patient's medical images and reports.

  4. The theory of planned behaviour in medical education: a model for integrating professionalism training.

    Science.gov (United States)

    Archer, Ray; Elder, William; Hustedde, Carol; Milam, Andrea; Joyce, Jennifer

    2008-08-01

    Teaching and evaluating professionalism remain important issues in medical education. However, two factors hinder attempts to integrate curricular elements addressing professionalism into medical school training: there is no common definition of medical professionalism used across medical education, and there is no commonly accepted theoretical model upon which to integrate professionalism into the curriculum. This paper proposes a definition of professionalism, examines this definition in the context of some of the previous definitions of professionalism and connects this definition to the attitudinal roots of professionalism. The problems described above bring uncertainty about the best content and methods with which to teach professionalism in medical education. Although various aspects of professionalism have been incorporated into medical school curricula, content, teaching and evaluation remain controversial. We suggest that intervening variables, which may augment or interfere with medical students' implementation of professionalism knowledge, skills and, therefore, attitudes, may go unaddressed. We offer a model based on the theory of planned behaviour (TPB), which describes the relationships of attitudes, social norms and perceived behavioural control with behaviour. It has been used to predict a wide range of behaviours, including doctor professional behaviours. Therefore, we propose an educational model that expands the TPB as an organisational framework that can integrate professionalism training into medical education. We conclude with a discussion about the implications of using this model to transform medical school curricula to develop positive professionalism attitudes, alter the professionalism social norms of the medical school and increase students' perceived control over their behaviours.

  5. The Integrated Medical Model: A Decision Support Tool for In-flight Crew Health Care

    Science.gov (United States)

    Butler, Doug

    2009-01-01

    This viewgraph presentation reviews the development of an Integrated Medical Model (IMM) decision support tool for in-flight crew health care safety. Clinical methods, resources, and case scenarios are also addressed.

  6. In Defense of Four Principles Approach in Medical Ethics

    Directory of Open Access Journals (Sweden)

    S Dabbagh

    2008-06-01

    Full Text Available "nPrinciplism, in general and Four Principles Approach in particular is largely discussed in current medical ethics. Accord­ing to principlism, the ethical relationship between physician and patient has to be categorized based on some princi­ples, the prin­ciples which are general, action-guiding and could help both the patient and the physician to arrange their ethical behav­ior. Four Principles Approach which is a principlistic view, has formulated the princi­ples which have to be considered in medi­cal ethics in the light of Rossian ethical framework as follows: respect for auton­omy, nonmalefi­cience, beneficence and jus­tice. Ethical Particularism, on the other hand, strongly criticizes princi­plism and repudi­ates the very idea of generalizabil­ity in the realm of ethics. According to particularists, the way in which a mor­ally relevant feature like fidelity and justice be­have in different ethical occasions is fully con­text-dependent so that they can­not be patternable in advance. It follows from this that fidelity, for instance, is not a good-making feature, generally speak­ing."nIn this paper, firstly, the Rossian ethics is discussed in order to make Four Principles Approach intelligible. Sec­ondly, the main particularists' argument against principlism is formulated. Finally, Particularists' argument is evalu­ated and its plau­si­bility is discussed.

  7. Teaching Service Modelling to a Mixed Class: An Integrated Approach

    Science.gov (United States)

    Deng, Jeremiah D.; Purvis, Martin K.

    2015-01-01

    Service modelling has become an increasingly important area in today's telecommunications and information systems practice. We have adapted a Network Design course in order to teach service modelling to a mixed class of both the telecommunication engineering and information systems backgrounds. An integrated approach engaging mathematics teaching…

  8. Helping Abused and Traumatized Children: Integrating Directive and Nondirective Approaches

    Science.gov (United States)

    Gil, Eliana

    2006-01-01

    Presenting an integrative model for treating traumatized children, this book combines play, art, and other expressive therapies with ideas and strategies drawn from cognitive-behavioral and family therapy. Eliana Gil demonstrates how to tailor treatment to the needs of each child by using both directive and nondirective approaches. Throughout,…

  9. An Integrated Approach to Disability Policy Development, Implementation, and Evaluation

    Science.gov (United States)

    Shogren, Karrie A.; Luckasson, Ruth; Schalock, Robert L.

    2017-01-01

    This article provides a framework for an integrated approach to disability policy development, implementation, and evaluation. The article discusses how a framework that combines systems thinking and valued outcomes can be used by coalition partners across ecological systems to implement disability policy, promote the effective use of resources,…

  10. Integration of Task-Based Approaches in a TESOL Course

    Science.gov (United States)

    Chien, Chin-Wen

    2014-01-01

    Under task-based language teaching (TBLT), language learners engage in purposeful, problem-oriented, and outcome-driven tasks that are comparable to real-world activities. This qualitative case study discusses the integration of a task-based approach into a TESOL course in a language teacher education program in Taiwan with regard to 39…

  11. Strategic competence management in global service networks: An integrated approach

    OpenAIRE

    Faix, Axel; Budde, Lukas; Friedli, Thomas

    2015-01-01

    The paper is based on an industry project in the pharmaceutical industry and describes a holistic approach to integrate competence management, capacity planning and strategic forecasting in the field of service operations in a global service network. Goal of the paper is to introduce a methodology combining operations and strategic management.

  12. Integrated Approach to Diagnosis of Associated Occupational Asthma and Rhinitis

    Directory of Open Access Journals (Sweden)

    Sébastien Nguyen

    2012-01-01

    Full Text Available Patients with coexisting work-related rhinitis and asthma would benefit from an adequate and simultaneous recognition of both diseases. The present case illustrates the advantages and importance of using an integrated approach to confirm a diagnosis of occupational rhinitis (OR and occupational asthma (OA.

  13. An Integrated Approach to Teaching Literature in an EFL Classroom

    Science.gov (United States)

    Yimwilai, Supaporn

    2015-01-01

    This research studied the effectiveness of the integrated approach in English as a Foreign Language (EFL) classrooms and how it related to students' 1) achievements, 2) critical thinking skills, and 3) attitudes toward reading literature. To ensure that the results were accurate and reliable, the experiment was conducted in two different regions.…

  14. Ontology Integration Approaches and its Impact on Text Categorization

    Directory of Open Access Journals (Sweden)

    Hamid Machhour

    2013-06-01

    Full Text Available This article will introduce some approaches for improving text categorization models by integratingpreviously imported ontologies. From the Reuters Corpus Volume I (RCV1 dataset, some categories verysimilar in content and related to telecommunications, Internet and computer areas were selected for modelsexperiments. Several domain ontologies, covering these areas were built and integrated to categorizationmodels for their improvements.

  15. A path integral approach to asset-liability management

    NARCIS (Netherlands)

    Decamps, M.; de Schepper, A.; Goovaerts, M.J.

    2006-01-01

    Functional integrals constitute a powerful tool in the investigation of financial models. In the recent econophysics literature, this technique was successfully used for the pricing of a number of derivative securities. In the present contribution, we introduce this approach to the field of asset-li

  16. Medication therapy disease management: Geisinger's approach to population health management.

    Science.gov (United States)

    Jones, Laney K; Greskovic, Gerard; Grassi, Dante M; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R; Murray, Michael F; Manickam, Kandamurugu; Nathanson, Douglas C; Wright, Eric A; Evans, Michael A

    2017-09-15

    Pharmacists' involvement in a population health initiative focused on chronic disease management is described. Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS). Over a 15-year period, Geisinger Health Plan (GHP)-insured patients with AF whose warfarin therapy was managed by the MTDM program had, on average, 18% fewer emergency department (ED) visits and 18% fewer hospitalizations per year than GHP enrollees with AF who did not receive MTDM services, with 23% lower annual total care costs. Over a 2-year period, GHP-insured patients with MS whose pharmacotherapy was managed by pharmacists averaged 28% fewer annual ED visits than non-pharmacist-managed patients; however, the mean annual total care cost was 21% higher among MTDM clinic patients. The Geisinger MTDM program has evolved over 20 years from a single pharmacist-run anticoagulation clinic into a large program focused on managing the health of an ever-growing population. Initial challenges in integrating pharmacists into the Geisinger patient care framework as clinical experts were overcome by demonstrating the MTDM program's positive impact on patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  17. The NASA Science Internet: An integrated approach to networking

    Science.gov (United States)

    Rounds, Fred

    1991-01-01

    An integrated approach to building a networking infrastructure is an absolute necessity for meeting the multidisciplinary science networking requirements of the Office of Space Science and Applications (OSSA) science community. These networking requirements include communication connectivity between computational resources, databases, and library systems, as well as to other scientists and researchers around the world. A consolidated networking approach allows strategic use of the existing science networking within the Federal government, and it provides networking capability that takes into consideration national and international trends towards multivendor and multiprotocol service. It also offers a practical vehicle for optimizing costs and maximizing performance. Finally, and perhaps most important to the development of high speed computing is that an integrated network constitutes a focus for phasing to the National Research and Education Network (NREN). The NASA Science Internet (NSI) program, established in mid 1988, is structured to provide just such an integrated network. A description of the NSI is presented.

  18. Integrated Fluency Instruction: Three Approaches for Working with Struggling Readers

    Directory of Open Access Journals (Sweden)

    Melanie KUHN

    2014-10-01

    Full Text Available Effective fluency instruction should focus on reading with understanding, rather than simply reading quickly or expressively. This article outlines three research-based instructional approaches that assist students in developing accurate, automatic word recognition and prosody; at the same time, they ensure learners attend to the text’s meaning as they read. All three approaches integrate instructional principles known to improve reading fluency (modeling, scaffolding, repetition, and extensive opportunity for the reading of connected text. They are also clear and easy-to-implement and have proven successful with struggling readers. As a result, these approaches contribute to learners’ reading success both within and outside of the classroom.

  19. An Integrated Approach to Flexible Modelling and Animated Simulation

    Institute of Scientific and Technical Information of China (English)

    Li Shuliang; Wu Zhenye

    1994-01-01

    Based on the software support of SIMAN/CINEMA, this paper presents an integrated approach to flexible modelling and simulation with animation. The methodology provides a structured way of integrating mathematical and logical model, statistical experinentation, and statistical analysis with computer animation. Within this methodology, an animated simulation study is separated into six different activities: simulation objectives identification , system model development, simulation experiment specification, animation layout construction, real-time simulation and animation run, and output data analysis. These six activities are objectives driven, relatively independent, and integrate through software organization and simulation files. The key ideas behind this methodology are objectives orientation, modelling flexibility,simulation and animation integration, and application tailorability. Though the methodology is closely related to SIMAN/CINEMA, it can be extended to other software environments.

  20. How Iranian Medical Trainees Approach their Responsibilities in Clinical Settings; A Grounded Theory Research

    Directory of Open Access Journals (Sweden)

    Omid Asemani

    2015-09-01

    Full Text Available Background: It seems we are now experiencing “responsibility problems” among medical trainees (MTs and some of those recently graduated from medical schools in Iran. Training responsible professionals have always been one of the main concerns of medical educators. Nevertheless, there is a dearth of research in the literature on “responsibility” especially from the medical education point of view. Therefore, the present study was carried out with the aim of presenting a theoretical based framework for understanding how MTs approach their responsibilities in educational settings. Method: This qualitative study was conducted at Shiraz University of Medical Sciences (SUMS using the grounded theory methodology. 15 MTs and 10 clinical experts and professional nurses were purposefully chosen as participants. Data was analyzed using the methodology suggested by Corbin and Strauss, 1998. Results: “Try to find acceptance toward expectations”, “try to be committed to meet the expectations” and “try to cope with unacceptable expectations” were three main categories extracted based on the research data. Abstractly, the main objective for using these processes was “to preserve the integrity of student identity” which was the core category of this research too. Moreover, it was also found that practically, “responsibility” is considerably influenced by lots of positive and negative contextual and intervening conditions. Conclusion: “Acceptance” was the most decisive variable highly effective in MTs’ responsibility. Therefore, investigating the “process of acceptance” regarding the involved contextual and intervening conditions might help medical educators correctly identify and effectively control negative factors and reinforce the constructive ones that affect the concept of responsibility in MTs.

  1. The evolution of integrative medical education:the influence of the University of Arizona Center for Integrative Medicine

    Institute of Scientific and Technical Information of China (English)

    Victoria Maizes; Randy Horwitz; Patricia Lebensohn; Hilary McClafferty; James Dalen; Andrew Weil

    2015-01-01

    The University of Arizona Center for Integrative Medicine (AzCIM) was founded in 1994 with a primary focus of educating physicians in integrative medicine (IM). Twenty years later, IM has become an international y recognized movement in medicine. With 40% of United States’ medical schools having membership in the Academic Consortium for Integrative Medicine and Health it is foreseeable that al medical students and residents wil soon receive training in the principles and practices of IM. The AzCIM has the broadest range and depth of IM educational programs and has had a major influence on integrative medical education in the United States. This review describes the fel owship, residency and medical student programs at AzCIM as wel as other significant national drivers of IM education; it also points out the chal enges faced in developing IM initiatives. The field of IM has matured with new national board certification in IM requiring fel owship training. Al ied health professional IM educational courses, as wel as integrative health coaching, assure that al members of the health care team can receive training. This review describes the evolution of IM education and wil be helpful to academic centers, health care institutions, and countries seeking to introduce IM initiatives.

  2. Positive Impact of Integrating Histology and Physiology Teaching at a Medical School in China

    Science.gov (United States)

    Sherer, Renslow; Wan, Yu; Dong, Hongmei; Cooper, Brian; Morgan, Ivy; Peng, Biwen; Liu, Jun; Wang, Lin; Xu, David

    2014-01-01

    To modernize its stagnant, traditional curriculum and pedagogy, the Medical School of Wuhan University in China adopted (with modifications) the University of Chicago's medical curriculum model. The reform effort in basic sciences was integrating histology and physiology into one course, increasing the two subjects' connection to…

  3. A Integracao de Ensino das Ciencias da Saude (An Integrated Medical Education Program [in Brazil]).

    Science.gov (United States)

    Pourchet-Campos, M. A.; Guimaraes Junior, Paulino

    At the Sixth Annual Reunion of the Brazilian Association of Medical Schools (VI Reuniao Anual da Associacao Brasileira de Escolas Medicas) leaders in the Brazilian medical profession proposed an integrated educational program for training students in the fields of medicine and public health. Under Brazil's present system of education, all…

  4. Positive Impact of Integrating Histology and Physiology Teaching at a Medical School in China

    Science.gov (United States)

    Sherer, Renslow; Wan, Yu; Dong, Hongmei; Cooper, Brian; Morgan, Ivy; Peng, Biwen; Liu, Jun; Wang, Lin; Xu, David

    2014-01-01

    To modernize its stagnant, traditional curriculum and pedagogy, the Medical School of Wuhan University in China adopted (with modifications) the University of Chicago's medical curriculum model. The reform effort in basic sciences was integrating histology and physiology into one course, increasing the two subjects' connection to clinical…

  5. An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience.

    Science.gov (United States)

    Hoppmann, Richard A; Rao, Victor V; Poston, Mary Beth; Howe, Duncan B; Hunt, Patrick S; Fowler, Stanley D; Paulman, Lance E; Wells, James R; Richeson, Nancy A; Catalana, Paul V; Thomas, Lynn K; Britt Wilson, L; Cook, Thomas; Riffle, Shaun; Neuffer, Francis H; McCallum, James B; Keisler, Brian D; Brown, Rachel S; Gregg, Anthony R; Sims, Kerry M; Powell, Caroline K; Garber, Matthew D; Morrison, James E; Owens, William B; Carnevale, Kevin A; Jennings, William R; Fletcher, Sarah

    2011-04-01

    A review of the development and implementation of a 4-year medical student integrated ultrasound curriculum is presented. Multiple teaching and assessment modalities are discussed as well as results from testing and student surveys. Lessons learned while establishing the curriculum are summarized. It is concluded that ultrasound is a well received, valuable teaching tool across all 4 years of medical school, and students learn ultrasound well, and they feel their ultrasound experience enhances their medical education.

  6. Self-Referent Constructs and Medical Sociology: In Search of an Integrative Framework*

    Science.gov (United States)

    Kaplan, Howard B.

    2010-01-01

    A theoretical framework centering on four classes of self-referent constructs is offered as a device for integrating the diverse areas constituting medical sociology. Guidance by this framework sensitizes the researcher to the occurrence of parallel processes in adjacent disciplines, facilitates recognition of the etiological significance of findings from other disciplines for explaining medical sociological phenomena, and encourages transactions between sociology and medical sociology whereby each informs and is informed by the other. PMID:17583268

  7. Self-Referent Constructs and Medical Sociology: In Search of an Integrative Framework*

    OpenAIRE

    Kaplan, Howard B.

    2007-01-01

    A theoretical framework centering on four classes of self-referent constructs is offered as a device for integrating the diverse areas constituting medical sociology. Guidance by this framework sensitizes the researcher to the occurrence of parallel processes in adjacent disciplines, facilitates recognition of the etiological significance of findings from other disciplines for explaining medical sociological phenomena, and encourages transactions between sociology and medical sociology whereb...

  8. How lead consultants approach educational change in postgraduate medical education.

    NARCIS (Netherlands)

    Fokkema, J.P.; Westerman, M.; Teunissen, P.W.; Lee, N.; Scherpbier, A.J.J.A.; Vleuten, C.P.M. van der; Dorr, P.J.; Scheele, F.

    2012-01-01

    CONTEXT: Consultants in charge of postgraduate medical education (PGME) in hospital departments ('lead consultants') are responsible for the implementation of educational change. Although difficulties in innovating in medical education are described in the literature, little is known about how lead

  9. Science of Integrated Approaches to Natural Resources Management

    Science.gov (United States)

    Tengberg, Anna; Valencia, Sandra

    2017-04-01

    To meet multiple environmental objectives, integrated programming is becoming increasingly important for the Global Environmental Facility (GEF), the financial mechanism of the multilateral environmental agreements, including the United Nations Convention to Combat Desertification (UNCCD). Integration of multiple environmental, social and economic objectives also contributes to the achievement of the Sustainable Development Goals (SDGs) in a timely and cost-effective way. However, integration is often not well defined. This paper therefore focuses on identifying key aspects of integration and assessing their implementation in natural resources management (NRM) projects. To that end, we draw on systems thinking literature, and carry out an analysis of a random sample of GEF integrated projects and in-depth case studies demonstrating lessons learned and good practices in addressing land degradation and other NRM challenges. We identify numerous challenges and opportunities of integrated approaches that need to be addressed in order to maximise the catalytic impact of the GEF during problem diagnosis, project design, implementation and governance. We highlight the need for projects to identify clearer system boundaries and main feedback mechanisms within those boundaries, in order to effectively address drivers of environmental change. We propose a theory of change for Integrated Natural Resources Management (INRM) projects, where short-term environmental and socio-economic benefits will first accrue at the local level. Implementation of improved INRM technologies and practices at the local level can be extended through spatial planning, strengthening of innovation systems, and financing and incentive mechanisms at the watershed and/or landscape/seascape level to sustain and enhance ecosystem services at larger scales and longer time spans. We conclude that the evolving scientific understanding of factors influencing social, technical and institutional innovations and

  10. Teaching Physiology in integrated basic medical sciences – sharing experiences from Nepal.

    Directory of Open Access Journals (Sweden)

    Pradhan AK

    2013-12-01

    Full Text Available Physiology is the basis of the medical profession [1]. Clear understanding of the mechanisms of the body functions always requires a high level of integration, apart from a descriptive approach [2, 3]. I worked as Professor in the Manipal College of Medical Sciences (MCOMS, Pokhara in the year 2009 -2010. Although my stay in Nepal was relatively short period, but the medical education system in Nepal influenced me. In Nepal, a traditional way of teaching pattern which is lecture-based, teacher-centered, discipline-based, examination-driven, and hospital-oriented is followed. Basic sciences and clinical sciences are the two main part of the medical curriculum in Nepal. The Bachelor of Medicine and Bachelor of Surgery degree is a four and half year's program, which is followed by one year internship. A large number of new medical colleges are coming up under Nepal Medical Council guidelines. There is a growing demand of Physicians in Nepal. Currently there are 18 medical colleges under Nepal Medical Council [4]. Manipal College of Medical Sciences is under Kathmandu University, one of the best and leading medical institutes in the country. This medical college is located in Pokhara. Students hailing from Nepal, India, Sri Lanka and other countries attend the four and a half year undergraduate medical (MBBS course. The MBBS course in Nepal is divided into nine semesters. Basic science subjects include Anatomy, Physiology, Biochemistry, Microbiology, Pathology, Pharmacology and Community Medicine which are taught in an integrated manner during the first four semesters (two years period. Community Medicine continues as a part of syllabus till the seventh semester and the clinical subjects like Medicine, Surgery, OBG, Ophthalmology, Orthopedics, Dermatology etc. are taught during the last five semesters of the MBBS course. At present Tribhuvan University (TU, Kathmandu University (KU, BP Koirala Institute of Health Sciences (BPKIHS and NAMS (National

  11. Integrative medical therapy: examination of meditation's therapeutic and global medicinal outcomes via nitric oxide (review).

    Science.gov (United States)

    Stefano, George B; Esch, Tobias

    2005-10-01

    Relaxation techniques are part of the integrative medicine movement that is of growing importance for mainstream medicine. Complementary medical therapies have the potential to affect many physiological systems. Repeatedly studies show the benefits of the placebo response and relaxation techniques in the treatment of hypertension, cardiac arrhythmias, chronic pain, insomnia, anxiety and mild and moderate depression, premenstrual syndrome, and infertility. In itself, relaxation is characterized by a decreased metabolism, heart rate, blood pressure, and rate of breathing as well as an increase in skin temperature. Relaxation approaches, such as progressive muscle relaxation, autogenic training, meditation and biofeedback, are effective in lowering systolic and diastolic blood pressure in hypertensive patients by a significant margin. Given this association with changes in vascular tone, we have hypothesized that nitric oxide, a demonstrated vasodilator substance, contribute to physiological activity of relaxation approaches. We examined the scientific literature concerning the disorders noted earlier for their nitric oxide involvement in an attempt to provide a molecular rationale for the positive effects of relaxation approaches, which are physiological and cognitive process. We conclude that constitutive nitric oxide may crucially contribute to potentially beneficial outcomes and effects in diverse pathologies, exerting a global healing effect.

  12. MEDLINE training for medical students integrated into the clinical curriculum.

    Science.gov (United States)

    Schwartz, D G; Schwartz, S A

    1995-03-01

    This study was initiated in response to the availabilty of unlimited access to MEDLINE via the PaperChase interface at the host institution. The goal of the study was to analyse the usage of MEDLINE by medical students during their third-year clinical clerkship in paediatrics. This was achieved by first giving them a formal demonstration of MEDLINE and then longitudinally administering a structured questionnaire at several points during their paediatric clerkship. Since medical students were required to write a thesis for this clerkship, which included an analysis of the primary literature, there was an identified need for using the system. This study analyses the students' perceptions and searching activities after formal training and upon having unlimited access to MEDLINE.

  13. Approaches and Study Skills of Veterinary Medical Students: Effects of a Curricular Revision.

    Science.gov (United States)

    Zamor, Eliza; Chigerwe, Munashe; Boudreaux, Karen A; Ilkiw, Jan E

    2017-01-01

    The objective of this study was to determine if a revised, recently implemented curriculum, embracing an integrated block design with a focus on student-centered, inquiry-based learning, had a different effect on veterinary medical students' approaches to studying than the previous curriculum. A total of 577 students completed a questionnaire consisting of the short version of the Approaches and Study Skills Inventory for Students (ASSIST). It included questions relating to conceptions about learning, approaches to studying, and preferences for different types of courses and teaching. In addition, students were asked to respond to general questions regarding the design of the revised curriculum. The scores for the deep and strategic learning approaches were higher for students studying under the previous curriculum compared to the revised curriculum, despite the fact that the revised curriculum was specifically designed to foster deep learning. The scores for the surface learning approach were lower in the students studying the revised curriculum compared to students studying under the previous curriculum. We identified the following factors affecting student learning: alteration of learning activities, such as problem-based learning, from the recommended models; a lack of instructor support for the revised curriculum; assessments that were not aligned to encourage critical thinking; and directed self-learning activities that were too comprehensive to complete in the allotted time. The results of this study can be used to improve the implementation of student-centered and inquiry-based curricula by identifying potential problems that could prevent a deep learning approach in veterinary medical students.

  14. Integrating Software Repository Mining: A Decision Support Centered Approach

    Directory of Open Access Journals (Sweden)

    Luiz Dourado Dias Junior

    2012-12-01

    Full Text Available Mining software repositories (MSR research had significantly contributed to software engineering.However, MSR results integration across repositories is a recent concern that is getting more attentionfrom researchers each day. Some noticeable research in this sense is related to the approximation betweenMSR and semantic web, specially linked data approaches which makes it possible to integrate repositoriesand mined results. Manifested that way, we believe that current research is not fully addressing thepractical integration of MSR results, specially, in software engineering due to not considering that theseresults needs to be integrated to the tools as assistance to activity performers, as a kind of decision makingsupport. Based on this statement this research describes an approach, named Sambasore, which isconcerned with MSR results inter-repository integration and also to decision making support processes,based on tool assistance modelling. To show its feasibility we describe the main concepts, some relatedworks and also a proof of concept experiment applied to a software process modelling tool named SpiderPM.

  15. Graph-based sequence annotation using a data integration approach.

    Science.gov (United States)

    Pesch, Robert; Lysenko, Artem; Hindle, Matthew; Hassani-Pak, Keywan; Thiele, Ralf; Rawlings, Christopher; Köhler, Jacob; Taubert, Jan

    2008-08-25

    The automated annotation of data from high throughput sequencing and genomics experiments is a significant challenge for bioinformatics. Most current approaches rely on sequential pipelines of gene finding and gene function prediction methods that annotate a gene with information from different reference data sources. Each function prediction method contributes evidence supporting a functional assignment. Such approaches generally ignore the links between the information in the reference datasets. These links, however, are valuable for assessing the plausibility of a function assignment and can be used to evaluate the confidence in a prediction. We are working towards a novel annotation system that uses the network of information supporting the function assignment to enrich the annotation process for use by expert curators and predicting the function of previously unannotated genes. In this paper we describe our success in the first stages of this development. We present the data integration steps that are needed to create the core database of integrated reference databases (UniProt, PFAM, PDB, GO and the pathway database Ara-Cyc) which has been established in the ONDEX data integration system. We also present a comparison between different methods for integration of GO terms as part of the function assignment pipeline and discuss the consequences of this analysis for improving the accuracy of gene function annotation. The methods and algorithms presented in this publication are an integral part of the ONDEX system which is freely available from http://ondex.sf.net/.

  16. SPATIAL DATA INTEGRATION USING ONTOLOGY-BASED APPROACH

    Directory of Open Access Journals (Sweden)

    S. Hasani

    2015-12-01

    Full Text Available In today's world, the necessity for spatial data for various organizations is becoming so crucial that many of these organizations have begun to produce spatial data for that purpose. In some circumstances, the need to obtain real time integrated data requires sustainable mechanism to process real-time integration. Case in point, the disater management situations that requires obtaining real time data from various sources of information. One of the problematic challenges in the mentioned situation is the high degree of heterogeneity between different organizations data. To solve this issue, we introduce an ontology-based method to provide sharing and integration capabilities for the existing databases. In addition to resolving semantic heterogeneity, better access to information is also provided by our proposed method. Our approach is consisted of three steps, the first step is identification of the object in a relational database, then the semantic relationships between them are modelled and subsequently, the ontology of each database is created. In a second step, the relative ontology will be inserted into the database and the relationship of each class of ontology will be inserted into the new created column in database tables. Last step is consisted of a platform based on service-oriented architecture, which allows integration of data. This is done by using the concept of ontology mapping. The proposed approach, in addition to being fast and low cost, makes the process of data integration easy and the data remains unchanged and thus takes advantage of the legacy application provided.

  17. [Application of supply chain integration management of medical consumables].

    Science.gov (United States)

    Zhang, Jian

    2013-07-01

    This paper introduces the background, the content, the information management system of material supply chain integration management and the consumables management process. The system helps to expand the selection of hospital supplies varieties, to reduce consumables management costs, to improve the efficiency of supplies, to ensure supplies safety, reliability and traceability.

  18. Integrated absence management and the Family and Medical Leave Act.

    Science.gov (United States)

    Morris, Judy A

    2008-05-01

    Intermittent unscheduled absenteeism often challenges employers to meet the needs of their employees, control direct absenteeism costs, and maintain the staff needed to serve customers. Occupational health nurses have opportunities to play an important role in addressing this challenge. Measurable financial impacts have been demonstrated from integrating the management of intermittent FMLA leave with an employer's existing absence management program.

  19. Integrating the Chronic Care Model into a Novel Medical Student Course

    Science.gov (United States)

    Block, Robert C.; Tran, Bill; McIntosh, Scott

    2011-01-01

    Objective: To determine whether integration of the Chronic Care Model into undergraduate medical education is associated with anticipated use of the Model and whether student perceptions match actual integration of the Model into their community projects. Design: This was a cross-sectional study using qualitative and quantitative data. Setting: A…

  20. A mixed transform approach for efficient compression of medical images.

    Science.gov (United States)

    Ramaswamy, A; Mikhael, W B

    1996-01-01

    A novel technique is presented to compress medical data employing two or more mutually nonorthogonal transforms. Both lossy and lossless compression implementations are considered. The signal is first resolved into subsignals such that each subsignal is compactly represented in a particular transform domain. An efficient lossy representation of the signal is achieved by superimposing the dominant coefficients corresponding to each subsignal. The residual error, which is the difference between the original signal and the reconstructed signal is properly formulated. Adaptive algorithms in conjunction with an optimization strategy are developed to minimize this error. Both two-dimensional (2-D) and three-dimensional (3-D) approaches for the technique are developed. It is shown that for a given number of retained coefficients, the discrete cosine transform (DCT)-Walsh mixed transform representation yields a more compact representation than using DCT or Walsh alone. This lossy technique is further extended for the lossless case. The coefficients are quantized and the signal is reconstructed. The resulting reconstructed signal samples are rounded to the nearest integer and the modified residual error is computed. This error is transmitted employing a lossless technique such as the Huffman coding. It is shown that for a given number of retained coefficients, the mixed transforms again produces the smaller rms-modified residual error. The first-order entropy of the error is also smaller for the mixed-transforms technique than for the DCT, thus resulting in smaller length Huffman codes.

  1. Plasmonic properties of metal nanoislands: surface integral equations approach

    Science.gov (United States)

    Scherbak, S. A.; Lipovskii, A. A.

    2016-08-01

    The surface integral equations method is used to analyse the surface plasmon resonance position in a metal island film formed by non-interacting axisymmetrical prolate/oblate hemispheroids placed on a dielectric substrate. The approach is verified via the comparison of results obtained for a hemisphere on a substrate with the ones obtained using the multipole expansion method. The preference of the integral equations method is in obtaining a simple final analytical expression for a particle polarizability in which any dielectric function of a metal can be substituted. Such simple formulae for the hemispherical particle on the substrate and calculated dependences of the hemispheroid resonant wavelength on its aspect ratio are presented.

  2. Medical Dataset Classification: A Machine Learning Paradigm Integrating Particle Swarm Optimization with Extreme Learning Machine Classifier

    Directory of Open Access Journals (Sweden)

    C. V. Subbulakshmi

    2015-01-01

    Full Text Available Medical data classification is a prime data mining problem being discussed about for a decade that has attracted several researchers around the world. Most classifiers are designed so as to learn from the data itself using a training process, because complete expert knowledge to determine classifier parameters is impracticable. This paper proposes a hybrid methodology based on machine learning paradigm. This paradigm integrates the successful exploration mechanism called self-regulated learning capability of the particle swarm optimization (PSO algorithm with the extreme learning machine (ELM classifier. As a recent off-line learning method, ELM is a single-hidden layer feedforward neural network (FFNN, proved to be an excellent classifier with large number of hidden layer neurons. In this research, PSO is used to determine the optimum set of parameters for the ELM, thus reducing the number of hidden layer neurons, and it further improves the network generalization performance. The proposed method is experimented on five benchmarked datasets of the UCI Machine Learning Repository for handling medical dataset classification. Simulation results show that the proposed approach is able to achieve good generalization performance, compared to the results of other classifiers.

  3. Medical Dataset Classification: A Machine Learning Paradigm Integrating Particle Swarm Optimization with Extreme Learning Machine Classifier.

    Science.gov (United States)

    Subbulakshmi, C V; Deepa, S N

    2015-01-01

    Medical data classification is a prime data mining problem being discussed about for a decade that has attracted several researchers around the world. Most classifiers are designed so as to learn from the data itself using a training process, because complete expert knowledge to determine classifier parameters is impracticable. This paper proposes a hybrid methodology based on machine learning paradigm. This paradigm integrates the successful exploration mechanism called self-regulated learning capability of the particle swarm optimization (PSO) algorithm with the extreme learning machine (ELM) classifier. As a recent off-line learning method, ELM is a single-hidden layer feedforward neural network (FFNN), proved to be an excellent classifier with large number of hidden layer neurons. In this research, PSO is used to determine the optimum set of parameters for the ELM, thus reducing the number of hidden layer neurons, and it further improves the network generalization performance. The proposed method is experimented on five benchmarked datasets of the UCI Machine Learning Repository for handling medical dataset classification. Simulation results show that the proposed approach is able to achieve good generalization performance, compared to the results of other classifiers.

  4. An integrated approach towards future ballistic neck protection materials selection.

    Science.gov (United States)

    Breeze, John; Helliker, Mark; Carr, Debra J

    2013-05-01

    Ballistic protection for the neck has historically taken the form of collars attached to the ballistic vest (removable or fixed), but other approaches, including the development of prototypes incorporating ballistic material into the collar of an under body armour shirt, are now being investigated. Current neck collars incorporate the same ballistic protective fabrics as the soft armour of the remaining vest, reflecting how ballistic protective performance alone has historically been perceived as the most important property for neck protection. However, the neck has fundamental differences from the thorax in terms of anatomical vulnerability, flexibility and equipment integration, necessitating a separate solution from the thorax in terms of optimal materials selection. An integrated approach towards the selection of the most appropriate combination of materials to be used for each of the two potential designs of future neck protection has been developed. This approach requires evaluation of the properties of each potential material in addition to ballistic performance alone, including flexibility, mass, wear resistance and thermal burden. The aim of this article is to provide readers with an overview of this integrated approach towards ballistic materials selection and an update of its current progress in the development of future ballistic neck protection.

  5. Developing an integrated framework of problem-based learning and coaching psychology for medical education: a participatory research.

    Science.gov (United States)

    Wang, Qing; Li, Huiping; Pang, Weiguo; Liang, Shuo; Su, Yiliang

    2016-01-05

    Medical schools have been making efforts to develop their own problem-based learning (PBL) approaches based on their educational conditions, human resources and existing curriculum structures. This study aimed to explore a new framework by integrating the essential features of PBL and coaching psychology applicable to the undergraduate medical education context. A participatory research design was employed. Four educational psychology researchers, eight undergraduate medical school students and two accredited PBL tutors participated in a four-month research programme. Data were collected through participatory observation, focus groups, semi-structured interviews, workshop documents and feedback surveys and then subjected to thematic content analysis. The triangulation of sources and member checking were used to ensure the credibility and trustworthiness of the research process. Five themes emerged from the analysis: current experience of PBL curriculum; the roles of and relationships between tutors and students; student group dynamics; development of self-directed learning; and coaching in PBL facilitation. On the basis of this empirical data, a systematic model of PBL and coaching psychology was developed. The findings highlighted that coaching psychology could be incorporated into the facilitation system in PBL. The integrated framework of PBL and coaching psychology in undergraduate medical education has the potential to promote the development of the learning goals of cultivating clinical reasoning ability, lifelong learning capacities and medical humanity. Challenges, benefits and future directions for implementing the framework are discussed in this paper.

  6. Development and optimization of integrated course of medical microbiology and parasitology

    Institute of Scientific and Technical Information of China (English)

    Chang LIU; Ping HE; Wei ZHAO; Xiao-kui GUO

    2015-01-01

    The course of medical microbiology and parasitology is integrated with medical microbiology and human parasitology. It is an important basic medical course. Efficient utilization of existing teaching resources and promotion of further integration are actual requirements of the teaching reform. Integration experience of this course in recent years are summarized in this paper,from the aspects of teaching modes,teaching resources,evaluation system,and management measures,we concluded how to construct and optimize this course. We also focus on the encountered problems and countermeasures in the construction of the curriculum in this paper,so as to provide strategic guidance for the further development of medical microbiology and parasitology.

  7. Nutrition education of medical and dental students: innovation through curriculum integration.

    Science.gov (United States)

    Touger-Decker, Riva

    2004-02-01

    Nutrition is a necessary component of education in the health professions. Although often underplayed, nutrition is an integral facet of dental education, particularly because the oral cavity is the entry point to the gastrointestinal tract. This article addresses the current status of nutrition education in medical and dental schools, including the common themes, strategies, and challenges of integrating nutrition education in this venue, particularly in dental schools. The survival and progression of nutrition as a component of medical and dental education depends to a large extent on the creativity and innovative strategies used by educators and administrators in medical and dental schools and in training programs. A forward-thinking attitude with a focus on the integration of nutrition topics throughout the 4 y of medical or dental school and subsequent training programs will increase the potential for a successful program.

  8. A Sensor Middleware for integration of heterogeneous medical devices.

    Science.gov (United States)

    Brito, M; Vale, L; Carvalho, P; Henriques, J

    2010-01-01

    In this paper, the architecture of a modular, service-oriented, Sensor Middleware for data acquisition and processing is presented. The described solution was developed with the purpose of solving two increasingly relevant problems in the context of modern pHealth systems: i) to aggregate a number of heterogeneous, off-the-shelf, devices from which clinical measurements can be acquired and ii) to provide access and integration with an 802.15.4 network of wearable sensors. The modular nature of the Middleware provides the means to easily integrate pre-processing algorithms into processing pipelines, as well as new drivers for adding support for new sensor devices or communication technologies. Tests performed with both real and artificially generated data streams show that the presented solution is suitable for use both in a Windows PC or a Windows Mobile PDA with minimal overhead.

  9. Medical robotics and computer-integrated interventional medicine

    Science.gov (United States)

    Taylor, Russell H.

    2012-02-01

    Computer-Integrated Interventional Medicine (CIIM) promises to have a profound impact on health care in the next 20 years, much as and for many of the same reasons that the marriage of computers and information processing methods with other technology have had on manufacturing, transportation, and other sectors of our society. Our basic premise is that the steps of creating patient-specific computational models, using these models for planning, registering the models and plans with the actual patient in the operating room, and using this information with appropriate technology to assist in carrying out and monitoring the intervention are best viewed as part of a complete patient-specific intervention process that occurs over many time scales. Further, the information generated in computer-integrated interventions can be captured and analyzed statistically to improve treatment processes. This paper will explore these themes briefly, using examples drawn from our work at the Engineering Research Center for Computer-Integrated Surgical Systems and Technology (CISST ERC).

  10. On Line Service Composition in the Integrated Clinical Environment for eHealth and Medical Systems.

    Science.gov (United States)

    García-Valls, Marisol; Touahria, Imad Eddine

    2017-06-08

    Medical and eHealth systems are progressively realized in the context of standardized architectures that support safety and ease the integration of the heterogeneous (and often proprietary) medical devices and sensors. The Integrated Clinical Environment (ICE) architecture appeared recently with the goal of becoming a common framework for defining the structure of the medical applications as concerns the safe integration of medical devices and sensors. ICE is simply a high level architecture that defines the functional blocks that should be part of a medical system to support interoperability. As a result, the underlying communication backbone is broadly undefined as concerns the enabling software technology (including the middleware) and associated algorithms that meet the ICE requirements of the flexible integration of medical devices and services. Supporting the on line composition of services in a medical system is also not part of ICE; however, supporting this behavior would enable flexible orchestration of functions (e.g., addition and/or removal of services and medical equipment) on the fly. iLandis one of the few software technologies that supports on line service composition and reconfiguration, ensuring time-bounded transitions across different service orchestrations; it supports the design, deployment and on line reconfiguration of applications, which this paper applies to service-based eHealth domains. This paper designs the integration between ICE architecture and iLand middleware to enhance the capabilities of ICE with on line service composition and the time-bounded reconfiguration of medical systems based on distributed services. A prototype implementation of a service-based eHealth system for the remote monitoring of patients is described; it validates the enhanced capacity of ICE to support dynamic reconfiguration of the application services. Results show that the temporal cost of the on line reconfiguration of the eHealth application is bounded

  11. Integration of fiber optical shape sensing with medical visualization for minimal-invasive interventions

    Science.gov (United States)

    Paetz, Torben; Waltermann, Christian; Angelmahr, Martin; Ojdanic, Darko; Schade, Wolfgang; Witte, Michael; Hahn, Horst Karl

    2015-03-01

    We present a fiber optical shape sensing system that allows to track the shape of a standard telecom fiber with fiber Bragg grating. The shape sensing information is combined with a medical visualization platform to visualize the shape sensing information together with medical images and post-processing results like 3D models, vessel graphs, or segmentation results. The framework has a modular nature to use it for various medical applications like catheter or needle based interventions. The technology has potential in the medical area as it is MR-compatible and can easily be integrated in catheters and needles due to its small size.

  12. Teaching Service Modelling to a Mixed Class: An Integrated Approach

    Directory of Open Access Journals (Sweden)

    Jeremiah D. DENG

    2015-04-01

    Full Text Available Service modelling has become an increasingly important area in today's telecommunications and information systems practice. We have adapted a Network Design course in order to teach service modelling to a mixed class of both the telecommunication engineering and information systems backgrounds. An integrated approach engaging mathematics teaching with strategies such as problem-solving, visualization, and the use of examples and simulations, has been developed. From assessment on student learning outcomes, it is indicated that the proposed course delivery approach succeeded in bringing out comparable and satisfactory performance from students of different educational backgrounds.

  13. Teaching psychodynamic psychotherapy to psychiatric residents: an integrated approach.

    Science.gov (United States)

    Gastelum, Emily; Douglas, Carolyn J; Cabaniss, Deborah L

    2013-03-01

    There is enduring controversy in our field regarding the place for supportive interventions in psychodynamic psychotherapy. This controversy is reflected in the differing ways in which psychodynamic psychotherapy has been conceptualized and taught in psychiatric residency training programs. The authors propose an "integrated" approach for teaching psychodynamic psychotherapy to trainees. In the integrated model, psychodynamic psychotherapy is conceptualized as a form of therapy designed to (a) uncover unconscious elements that influence thoughts, feelings, and behavior, and (b) support weakened psychological function. Using this model, residents learning psychodynamic psychotherapy are taught both uncovering and supporting techniques side by side in one course with specific guidelines for assessing when to use one set of interventions or the other. Teaching psychodynamic psychotherapy to residents in this integrated way prepares them to become skilled clinicians who are able to move fluidly from supporting to uncovering in a pragmatic and flexible manner, matched to the particular moment-to-moment needs of the individual patient.

  14. Keeping the medical practice financially viable: a marketer's approach.

    Science.gov (United States)

    Patrick, Michelle L; Capraro, Anthony J; Credito, Candace M

    2002-01-01

    This paper explores a way that medical practices might develop a higher margin revenue source by offering a differentiated service that caters to patients who value more personalized service. Using SERVQUAL, German patients were surveyed to determine if there is a relationship between a desire for personalized service and a willingness to pay a premium for medical care. The results indicate that a greater desire for personalized care distinguishes those who pay a premium for medical care from those who do not. This suggests that medical practices can differentiate their service based on more personalized care and charge a higher fee for this service.

  15. Retrieval and management of medical information from heterogeneous sources, for its integration in a medical record visualisation tool.

    Science.gov (United States)

    Cabarcos, Alba; Sanchez, Tamara; Seoane, Jose A; Aguiar-Pulido, Vanessa; Freire, Ana; Dorado, Julian; Pazos, Alejandro

    2010-01-01

    Nowadays, medical practice needs, at the patient Point-of-Care (POC), personalised knowledge adjustable in each moment to the clinical needs of each patient, in order to provide support to decision-making processes, taking into account personalised information. To achieve this, adapting the hospital information systems is necessary. Thus, there is a need of computational developments capable of retrieving and integrating the large amount of biomedical information available today, managing the complexity and diversity of these systems. Hence, this paper describes a prototype which retrieves biomedical information from different sources, manages it to improve the results obtained and to reduce response time and, finally, integrates it so that it is useful for the clinician, providing all the information available about the patient at the POC. Moreover, it also uses tools which allow medical staff to communicate and share knowledge.

  16. First- and third-person approaches: the problem of integration

    OpenAIRE

    2012-01-01

    The author discusses the problem of integration of first- and third-person approaches in studying the human mind. She critically evaluates and compares various methodologies for studying and explaining conscious experience. Common strategies that apply reductive explanation seem to be unsatisfied for explaining experience and its subjective character. There were attempts to explain experience from the first-person point of view (introspectionism, philosophical phenomenology) but the results w...

  17. An Integrated approach to the Space Situational Awareness Problem

    Science.gov (United States)

    2016-12-15

    AFRL-AFOSR-VA-TR-2016-0377 An Integrated approach to the Space Situational Awareness Problem Suman Chakravorty TEXAS ENGINEERING EXPERIMENT STATION...including suggestions for reducing the burden, to the Department of Defense, Executive Service Directorate (0704-0188). Respondents should be aware that...Situational Awareness Problem 5a. CONTRACT NUMBER 5b. GRANT NUMBER FA9550-13-1-0074 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Dr. Suman Chakravorty 5d

  18. An innovation integrated approach to testing motorcycle drive chain lubricants

    OpenAIRE

    Lee, P.M.; Priest, M.

    2004-01-01

    An innovative integrated approach to the testing and comparison of motorcycle drive chain lubricants is presented. This is a novel way of testing the lubrication by using loaded operating chains and sprockets. A test rig has been designed to operate chains and sprockets in a clean environment and allow direct comparison between different lubricants. The advantage of this method over previous techniques is that it allows the differentiation of lubricants in a more controlled operating environm...

  19. An integrated micro-macro approach to robust railway timetabling

    DEFF Research Database (Denmark)

    Bešinović, Nikola; Goverde, Rob M P; Quaglietta, Egidio

    2016-01-01

    With the increasing demand for railway transportation infrastructure managers need improved automatic timetabling tools that provide feasible timetables with enhanced performance in short computation times. This paper proposes a hierarchical framework for timetable design which combines...... robustness using an Integer Linear Programming formulation which includes a measure for delay recovery computed by an integrated delay propagation model in a Monte Carlo setting. The application to an area of the Dutch railway network shows the ability of the approach to automatically compute a feasible...

  20. An integrated MCDM approach to green supplier selection

    OpenAIRE

    Morteza Yazdani

    2014-01-01

    Supplier selection management has been considered as an important subject for industrial organizations. In order to remain on the market, to gain profitability and to retain competitive advantage, business units need to establish an integrated and structured supplier selection system. In addition, environmental protection problems have been big solicitudes for organizations to consider green approach in supplier selection problem. However, finding proper suppliers involves several variables a...

  1. An Integrated Approach to the Assessment of Energy Conversion Plants

    OpenAIRE

    Simone Tonon; Anna Stoppato; Alberto Mirandola

    2010-01-01

    An integrated approach to the assessment of energy systems behaviour with regard to energetic, economic and environmental viewpoints is suggested. For each aspect, suitable performance indicators are defined, evaluated and then normalised in order that the same numerical value is calculated for qualitatively equivalent performances even if related to different aspects; application of these indicators can address policy makers, designers and plant operators towards a fair compromise a...

  2. Workplace mental health: developing an integrated intervention approach.

    Science.gov (United States)

    LaMontagne, Anthony D; Martin, Angela; Page, Kathryn M; Reavley, Nicola J; Noblet, Andrew J; Milner, Allison J; Keegel, Tessa; Smith, Peter M

    2014-05-09

    Mental health problems are prevalent and costly in working populations. Workplace interventions to address common mental health problems have evolved relatively independently along three main threads or disciplinary traditions: medicine, public health, and psychology. In this Debate piece, we argue that these three threads need to be integrated to optimise the prevention of mental health problems in working populations. To realise the greatest population mental health benefits, workplace mental health intervention needs to comprehensively 1) protect mental health by reducing work-related risk factors for mental health problems; 2) promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities; and 3) address mental health problems among working people regardless of cause. We outline the evidence supporting such an integrated intervention approach and consider the research agenda and policy developments needed to move towards this goal, and propose the notion of integrated workplace mental health literacy. An integrated approach to workplace mental health combines the strengths of medicine, public health, and psychology, and has the potential to optimise both the prevention and management of mental health problems in the workplace.

  3. [Integrative approach in the psychotherapy of borderline personality disorder].

    Science.gov (United States)

    Kuritárné Szabó, Ildikó

    2012-01-01

    In the last 20 years six psychotherapy methods have been developed specifically for borderline personality disorder. Solid RCT evidences suggests the efficacy of all the methods. Roughly equivalent improvement was obtained from the different types of psychotherapies. Today we have reached a new phase of the borderline "psychotherapy boom", the integrative approach. According to the integrative treatment advocates we should not choose among these effective treatments but we can incorporate in the therapy all the components that work. The integrative approach uses general factors common to all effective therapies, combined with specific treatment techniques taken from different therapies in order to treat the given patient's psychopathology. These common factors are: coherent framework; attention to strategies for building strong positive alliance and maintaining patient motivation; creating a safe and structured therapeutic environment; clear treatment frame; transparency of the goals and roles; focus upon presenting problems; higher level therapeutic activity; here-and-now focus; and facilitating self-reflection. Treatment focuses on change while maintaining a validating and supportive stance. General strategies can be supplemented by more specific techniques such as cognitive-behavioral interventions for reducing maladaptive behavior, training for developing emotion regulation skills and interpersonal skills coming from dialectical behavior therapy. Methods drawn from psychodynamic approaches can be used for the modification of underlying interpersonal cognitive-emotional schemas.

  4. EAU standardised medical terminology for urologic imaging: a taxonomic approach.

    Science.gov (United States)

    Loch, Tillmann; Carey, Brendan; Walz, Jochen; Fulgham, Pat Fox

    2015-05-01

    The terminology and abbreviations used in urologic imaging have generally been adopted on an ad hoc basis by different speciality groups; however, there is a need for shared nomenclature to facilitate clinical communication and collaborative research. This work reviews the current nomenclature for urologic imaging used in clinical practice and proposes a taxonomy and terminology for urologic imaging studies. A list of terms used in urologic imaging were compiled from guidelines published by the European Association of Urology and the American Urological Association and from the American College of Radiology Appropriateness Criteria. Terms searched were grouped into broad categories based on technology, and imaging terms were further stratified based on the anatomic extent, contrast or phases, technique or modifiers, and combinations or fusions. Terms that had a high degree of utilisation were classified as accepted. We propose a new taxonomy to define a more useful and acceptable nomenclature model acceptable to all health professionals involved in urology. The major advantage of a taxonomic approach to the classification of urologic imaging studies is that it provides a flexible framework for classifying the modifications of current imaging modalities and allows the incorporation of new imaging modalities. The adoption of this hierarchical classification model ranging from the most general to the most detailed descriptions should facilitate hierarchical searches of the medical literature using both general and specific terms. This work is limited in its scope, as it is not currently all-inclusive. This will hopefully be addressed by future modification as others embrace the concept and work towards uniformity in nomenclature. This paper provides a noncomprehensive list of the most widely used terms across different specialties. This list can be used as the basis for further discussion, development, and enhancement. In this paper we describe a classification system

  5. An Integrated Approach for Urban Earthquake Vulnerability Analyses

    Science.gov (United States)

    Düzgün, H. S.; Yücemen, M. S.; Kalaycioglu, H. S.

    2009-04-01

    The earthquake risk for an urban area has increased over the years due to the increasing complexities in urban environments. The main reasons are the location of major cities in hazard prone areas, growth in urbanization and population and rising wealth measures. In recent years physical examples of these factors are observed through the growing costs of major disasters in urban areas which have stimulated a demand for in-depth evaluation of possible strategies to manage the large scale damaging effects of earthquakes. Understanding and formulation of urban earthquake risk requires consideration of a wide range of risk aspects, which can be handled by developing an integrated approach. In such an integrated approach, an interdisciplinary view should be incorporated into the risk assessment. Risk assessment for an urban area requires prediction of vulnerabilities related to elements at risk in the urban area and integration of individual vulnerability assessments. However, due to complex nature of an urban environment, estimating vulnerabilities and integrating them necessities development of integrated approaches in which vulnerabilities of social, economical, structural (building stock and infrastructure), cultural and historical heritage are estimated for a given urban area over a given time period. In this study an integrated urban earthquake vulnerability assessment framework, which considers vulnerability of urban environment in a holistic manner and performs the vulnerability assessment for the smallest administrative unit, namely at neighborhood scale, is proposed. The main motivation behind this approach is the inability to implement existing vulnerability assessment methodologies for countries like Turkey, where the required data are usually missing or inadequate and decision makers seek for prioritization of their limited resources in risk reduction in the administrative districts from which they are responsible. The methodology integrates socio

  6. mHealth SMS text messaging interventions and to promote medication adherence: an integrative review.

    Science.gov (United States)

    DeKoekkoek, Tracy; Given, Barbara; Given, Charles W; Ridenour, Kimberly; Schueller, Monica; Spoelstra, Sandra L

    2015-10-01

    This article is an integrative review of the evidence for mobile health Short Message Service text messages as an innovative and emerging intervention to promote medication adherence. Authors completed this review to draw conclusions and implications towards establishing a scientific foundation for use of text messages to promote medication adherence, thus informing clinical practice. The World Health Organization has identified medication adherence as a priority global problem. Text messages are emerging as an effective means of improving health behaviours and in some diseases to promote medication adherence. However, a gap in the literature indicates lack of evidence in guiding theories and content of text messages, which should be synthesised prior to use in clinical practice. Integrative review. Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica dataBASE, Scopus, the Cochrane Library and PubMed were searched for relevant studies between 2004-2014. Inclusion criteria were (1) implementation of a text-message intervention and (2) medication adherence to a prescribed oral medication as a primary outcome. Articles were assessed for quality of methodology and measures of adherence. An integrative review process was used to perform analysis. Thirteen articles meeting the inclusion criteria are included in this review. Nine of 13 studies found adherence rates improved between 15·3-17·8% when using text messages to promote medication adherence. Text messages that were standardised, tailored, one- or two-way and timed either daily to medication regimen, weekly or monthly showed improvement in medication adherence. This review established a scientific basis for text messages as an intervention to improve medication adherence across multiple diseases. Future large rigorous randomised trials are needed to further test text messaging interventions. This review provides clinicians with the state of the science with regard to text messaging

  7. The Theory of Bio-Medical Knowledge Integration(Ⅵ)

    Institute of Scientific and Technical Information of China (English)

    BAO Han-fei

    2006-01-01

    This paper introduced the following new concepts:the cognitive goal, the cognitive goal for the declarative data of the patient records (PRs), The basic attributes of PR's data at the sides of generation, construction and cognition, the generalized data creator (GDC), type Ⅰ to Ⅵ+ of GDC, the cognitive directions of data: forward direction and backward direction, the apparent cognitive orientation and inapparent cognitive orientation, the cognitive granularity difference principle between the natural intelligence and the artificial intelligence, the generalized variable(GVAR) and the generalized value(GVAL), the variable and value transitivity law(V-V transitivity law), the attribute-combination irreversibility between the concept abstracting and embodying, an open model of the launching engine of bio-medical cognition, etc

  8. [Proposal of residency integrated with medical masters degree at the UFMG Medical School: an evaluation among residents].

    Science.gov (United States)

    Lamounier, J A; Pereira, A A; de Oliveira, H N

    1996-01-01

    A project which integrates medical RESIDENCY with medical masters degree has been discussed and is expected to be set up at UFMG Medical School in the near future. Such project is optional for the entering residents and aims those who are interested in becoming researchers. This paper's objective is to raise the residents' opinion on the project as well as their interests in post graduation level. A 240 university hospital residents (HC-UFMG) and a 114 non-university hospital (IPSEMG) were studied through questionnaire application. From the total population of 354 residents we had a 50% questionnaire devolution, 120 (68%) from HC-UFMG and 57 (32%) from IPSEMG. Residents of different clinical and surgical areas were included, 55% male and 45% female. Most of them work exclusively in residency activities, 69% have interest in specialize after residency, 55% in taking medical masters degree, 52% in taking up academic life and 67% in applying for the integrated residency-master degree program. Twelve (7%) are not particularly interested in join the program because they are not sure whether they are able to carry on adequately both residency and research activities at the same time. This study shows that residents are highly receptive to the UFMG's program and that more detailed information concerning its contents should be handed out in order to generate further discussion.

  9. A Multidisciplinary Approach to Sexual Dysfunction in Medical Education

    Science.gov (United States)

    Foley, Sallie; Wittmann, Daniela; Balon, Richard

    2010-01-01

    Objective: Addressing sexual health concerns in medical practice has been an emerging concept for the past two decades. However, there have been very few educational opportunities in medical training that would prepare future physicians for such a responsibility. Since assessing and treating sexual problems requires knowledge that encompasses many…

  10. Selecting Students for Medical Education : Exploring novel approaches

    NARCIS (Netherlands)

    S.M. Lucieer (Susanna)

    2016-01-01

    markdownabstractAbstract Medical schools all over the world have to select their students as the number of applicants highly exceeds the number of places available. In this dissertation, we examined why the current selection method employed by Erasmus MC Medical School is successful in

  11. Improving written and verbal communication skills for international medical graduates: a linguistic and medical approach.

    Science.gov (United States)

    Cross, Duncan; Smalldridge, Ann

    2011-01-01

    Adapting to UK communication styles can be difficult for International Medical Graduates (IMGs). Reache Northwest provides education, training and support for internationally trained refugee and asylum seeking health professionals who are looking to return to work in the UK. A Safe and Effective Communication Skills course was designed by a team of language teachers and clinicians to provide IMGs with an understanding of the written, verbal and summarisation skills required in the UK work environment. A series of language exercises adapted to clinical situations was developed. These increased in complexity to the practical application of language skills in clinical settings using simulated patients. The combination of language and clinical tutors meant that feedback could be given from a language teacher's perspective, the clinical perspective and the cultural context. The combination of language and clinical tutors meant that analysis of communication difficulties could be made from different perspectives and detailed, specific feedback could be given to each student in these areas. Using a combined linguistic and clinical approach can provide solutions to clinical communication problems that may otherwise be missed. This strategy could be extended to cover communication areas in other contexts.

  12. Findings from the Harvard Medical School Cambridge Integrated Clerkship, a Year-Long Longitudinal Psychiatry Experience.

    Science.gov (United States)

    Cheng, Elisa; Hirsh, David; Gaufberg, Elizabeth; Griswold, Todd; Wesley Boyd, J

    2017-06-23

    The Harvard Medical School Cambridge Integrated Clerkship is a longitudinal integrated clerkship that has provided an alternative clinical model for medical education in psychiatry since its inception in 2004. This study was undertaken in an effort to better understand the student experience of the Cambridge Integrated Clerkship and how it may have impacted students' perceptions of and interest in psychiatry, as well as performance. Qualitative surveys were sent via e-mail to the first 11 student cohorts who had completed the Cambridge Integrated Clerkship (from 2004 to 2014) and for whom we had e-mail addresses (N = 100), and the free-text responses were coded thematically. All available standardized scoring data and residency match data for Cambridge Integrated Clerkship graduates were obtained. From 2006 to 2014, 12 out of 73 Cambridge Integrated Clerkship students who entered the match chose a psychiatry residency (16.4%), four times more than students in traditional clerkships at Harvard Medical School (3.8% of 1355 students) or the national average (4.1% of 146,066 US applicants). Thirty of the 100 surveyed Cambridge Integrated Clerkship graduates (30%) responded to the qualitative survey with free-text remarks on a number of themes. Cambridge Integrated Clerkship students compared positively to their classmates in terms of standardized test performance. Their fourfold higher match rate into psychiatry compared to other students raises intriguing questions as to what role a longitudinal clerkship might have played in developing interest in psychiatry as a career.

  13. Systems Medicine: The Application of Systems Biology Approaches for Modern Medical Research and Drug Development

    Directory of Open Access Journals (Sweden)

    Duncan Ayers

    2015-01-01

    Full Text Available The exponential development of highly advanced scientific and medical research technologies throughout the past 30 years has arrived to the point where the high number of characterized molecular agents related to pathogenesis cannot be readily integrated or processed by conventional analytical approaches. Indeed, the realization that several moieties are signatures of disease has partly led to the increment of complex diseases being characterized. Scientists and clinicians can now investigate and analyse any individual dysregulations occurring within the genomic, transcriptomic, miRnomic, proteomic, and metabolomic levels thanks to currently available advanced technologies. However, there are drawbacks within this scientific brave new age in that only isolated molecular levels are individually investigated for their influence in affecting any particular health condition. Since their conception in 1992, systems biology/medicine focuses mainly on the perturbations of overall pathway kinetics for the consequent onset and/or deterioration of the investigated condition/s. Systems medicine approaches can therefore be employed for shedding light in multiple research scenarios, ultimately leading to the practical result of uncovering novel dynamic interaction networks that are critical for influencing the course of medical conditions. Consequently, systems medicine also serves to identify clinically important molecular targets for diagnostic and therapeutic measures against such a condition.

  14. Systems Medicine: The Application of Systems Biology Approaches for Modern Medical Research and Drug Development.

    Science.gov (United States)

    Ayers, Duncan; Day, Philip J

    2015-01-01

    The exponential development of highly advanced scientific and medical research technologies throughout the past 30 years has arrived to the point where the high number of characterized molecular agents related to pathogenesis cannot be readily integrated or processed by conventional analytical approaches. Indeed, the realization that several moieties are signatures of disease has partly led to the increment of complex diseases being characterized. Scientists and clinicians can now investigate and analyse any individual dysregulations occurring within the genomic, transcriptomic, miRnomic, proteomic, and metabolomic levels thanks to currently available advanced technologies. However, there are drawbacks within this scientific brave new age in that only isolated molecular levels are individually investigated for their influence in affecting any particular health condition. Since their conception in 1992, systems biology/medicine focuses mainly on the perturbations of overall pathway kinetics for the consequent onset and/or deterioration of the investigated condition/s. Systems medicine approaches can therefore be employed for shedding light in multiple research scenarios, ultimately leading to the practical result of uncovering novel dynamic interaction networks that are critical for influencing the course of medical conditions. Consequently, systems medicine also serves to identify clinically important molecular targets for diagnostic and therapeutic measures against such a condition.

  15. Extending the theoretical framework for curriculum integration in pre-clinical medical education.

    Science.gov (United States)

    Vergel, John; Stentoft, Diana; Montoya, Juny

    2017-08-01

    Curriculum integration is widely discussed in medical education but remains ill defined. Although there is plenty of information on logistical aspects of curriculum integration, little attention has been paid to the contextual issues that emerge from its practice and may complicate students' knowledge integration. Therefore, we aimed to uncover how curriculum integration is manifested through context. We collected data from the official curriculum and interviewed ten participants (including curriculum designers, facilitators, and students) in the bachelor's medical program at Aalborg University. We observed various learning activities focused on pre-clinical education. Inspired by grounded theory, we analyzed the information we gathered. The following theoretical constructs emerged after the inductive analysis: 1) curriculum integration complexity is embedded in the institutional learning perspectives; 2) curriculum integration is used to harmonize conflicting learning perspectives in curriculum practice; 3) curriculum integration creates tensions that self-organize its structure; and 4) curriculum integration becomes visible in collaborative learning spaces. These constructs provide a framework for analyzing curriculum integration in the context in which it is meant to appear, which may assist educationalists to gain a more specific understanding of the term. This may enable effective curriculum integration since contextual issues are addressed in addition to the goals specified in the official curriculum.

  16. Semantic Integration of Cervical Cancer Data Repositories to Facilitate Multicenter Association Studies: The ASSIST Approach

    Directory of Open Access Journals (Sweden)

    Theodoros Agorastos

    2009-02-01

    Full Text Available The current work addresses the unification of Electronic Health Records related to cervical cancer into a single medical knowledge source, in the context of the EU-funded ASSIST research project. The project aims to facilitate the research for cervical precancer and cancer through a system that virtually unifies multiple patient record repositories, physically located in different medical centers/hospitals, thus, increasing flexibility by allowing the formation of study groups “on demand” and by recycling patient records in new studies. To this end, ASSIST uses semantic technologies to translate all medical entities (such as patient examination results, history, habits, genetic profile and represent them in a common form, encoded in the ASSIST Cervical Cancer Ontology. The current paper presents the knowledge elicitation approach followed, towards the definition and representation of the disease’s medical concepts and rules that constitute the basis for the ASSIST Cervical Cancer Ontology. The proposed approach constitutes a paradigm for semantic integration of heterogeneous clinical data that may be applicable to other biomedical application domains.

  17. Medical case-based retrieval: integrating query MeSH terms for query-adaptive multi-modal fusion

    Science.gov (United States)

    Seco de Herrera, Alba G.; Foncubierta-Rodríguez, Antonio; Müller, Henning

    2015-03-01

    Advances in medical knowledge give clinicians more objective information for a diagnosis. Therefore, there is an increasing need for bibliographic search engines that can provide services helping to facilitate faster information search. The ImageCLEFmed benchmark proposes a medical case-based retrieval task. This task aims at retrieving articles from the biomedical literature that are relevant for differential diagnosis of query cases including a textual description and several images. In the context of this campaign many approaches have been investigated showing that the fusion of visual and text information can improve the precision of the retrieval. However, fusion does not always lead to better results. In this paper, a new query-adaptive fusion criterion to decide when to use multi-modal (text and visual) or only text approaches is presented. The proposed method integrates text information contained in MeSH (Medical Subject Headings) terms extracted and visual features of the images to find synonym relations between them. Given a text query, the query-adaptive fusion criterion decides when it is suitable to also use visual information for the retrieval. Results show that this approach can decide if a text or multi{modal approach should be used with 77.15% of accuracy.

  18. RISK MANAGEMENT: AN INTEGRATED APPROACH TO RISK MANAGEMENT AND ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Szabo Alina

    2012-12-01

    Full Text Available Purpose: The objective of this paper is to offer an overview over risk management cycle by focusing on prioritization and treatment, in order to ensure an integrated approach to risk management and assessment, and establish the ‘top 8-12’ risks report within the organization. The interface with Internal Audit is ensured by the implementation of the scoring method to prioritize risks collected from previous generated risk report. Methodology/approach: Using evidence from other research in the area and the professional expertise, this article outlines an integrated approach to risk assessment and risk management reporting processes, by separating the risk in two main categories: strategic and operational risks. The focus is on risk prioritization and scoring; the final output will comprise a mix of strategic and operational (‘top 8-12’ risks, which should be used to establish the annual Internal Audit plan. Originality/value: By using an integrated approach to risk assessment and risk management will eliminate the need for a separate Internal Audit risk assessment over prevailing risks. It will reduce the level of risk assessment overlap by different functions (Tax, Treasury, Information System over the same risk categories as a single methodology, is used and will align timings of risk assessment exercises. The risk prioritization by usage of risk and control scoring criteria highlights the combination between financial and non-financial impact criteria allowing risks that do not naturally lend themselves to a financial amount to be also assessed consistently. It is emphasized the usage of score method to prioritize the risks included in the annual audit plan in order to increase accuracy and timelines.

  19. Integrating cell biology and proteomic approaches in plants.

    Science.gov (United States)

    Takáč, Tomáš; Šamajová, Olga; Šamaj, Jozef

    2017-04-22

    Significant improvements of protein extraction, separation, mass spectrometry and bioinformatics nurtured advancements of proteomics during the past years. The usefulness of proteomics in the investigation of biological problems can be enhanced by integration with other experimental methods from cell biology, genetics, biochemistry, pharmacology, molecular biology and other omics approaches including transcriptomics and metabolomics. This review aims to summarize current trends integrating cell biology and proteomics in plant science. Cell biology approaches are most frequently used in proteomic studies investigating subcellular and developmental proteomes, however, they were also employed in proteomic studies exploring abiotic and biotic stress responses, vesicular transport, cytoskeleton and protein posttranslational modifications. They are used either for detailed cellular or ultrastructural characterization of the object subjected to proteomic study, validation of proteomic results or to expand proteomic data. In this respect, a broad spectrum of methods is employed to support proteomic studies including ultrastructural electron microscopy studies, histochemical staining, immunochemical localization, in vivo imaging of fluorescently tagged proteins and visualization of protein-protein interactions. Thus, cell biological observations on fixed or living cell compartments, cells, tissues and organs are feasible, and in some cases fundamental for the validation and complementation of proteomic data. Validation of proteomic data by independent experimental methods requires development of new complementary approaches. Benefits of cell biology methods and techniques are not sufficiently highlighted in current proteomic studies. This encouraged us to review most popular cell biology methods used in proteomic studies and to evaluate their relevance and potential for proteomic data validation and enrichment of purely proteomic analyses. We also provide examples of

  20. A web-based knowledge management system integrating Western and Traditional Chinese Medicine for relational medical diagnosis.

    Science.gov (United States)

    Herrera-Hernandez, Maria C; Lai-Yuen, Susana K; Piegl, Les A; Zhang, Xiao

    2016-10-26

    This article presents the design of a web-based knowledge management system as a training and research tool for the exploration of key relationships between Western and Traditional Chinese Medicine, in order to facilitate relational medical diagnosis integrating these mainstream healing modalities. The main goal of this system is to facilitate decision-making processes, while developing skills and creating new medical knowledge. Traditional Chinese Medicine can be considered as an ancient relational knowledge-based approach, focusing on balancing interrelated human functions to reach a healthy state. Western Medicine focuses on specialties and body systems and has achieved advanced methods to evaluate the impact of a health disorder on the body functions. Identifying key relationships between Traditional Chinese and Western Medicine opens new approaches for health care practices and can increase the understanding of human medical conditions. Our knowledge management system was designed from initial datasets of symptoms, known diagnosis and treatments, collected from both medicines. The datasets were subjected to process-oriented analysis, hierarchical knowledge representation and relational database interconnection. Web technology was implemented to develop a user-friendly interface, for easy navigation, training and research. Our system was prototyped with a case study on chronic prostatitis. This trial presented the system's capability for users to learn the correlation approach, connecting knowledge in Western and Traditional Chinese Medicine by querying the database, mapping validated medical information, accessing complementary information from official sites, and creating new knowledge as part of the learning process. By addressing the challenging tasks of data acquisition and modeling, organization, storage and transfer, the proposed web-based knowledge management system is presented as a tool for users in medical training and research to explore, learn and

  1. Supporting teachers integrating web 2.0 in a Problem Based Learning approach

    DEFF Research Database (Denmark)

    Buus, Lillian

    2010-01-01

    Based on theoretical and methodological considerations within problem-based learning (PBL), web 2.0 technologies and learning designs, the article try to illustrate a design model for supporting teachers in their learning design trying to integrate web 2.0 technologies into their PBL approach...... that a transition from curriculum-based teaching to PBL entails a movement from a teacher-centered approach to a learner-centered approach [4],[5]. This move can in many ways be compared to the conceptual move from web 1.0 to web 2.0 that by some is seen as a transition from ‘users/learners as consumers’ towards...... at Aalborg University (AAU). Problem-Based Learning (PBL) has gained a lot of interest since it was launched in established educational settings over 30 years ago in the medical programmes at McMaster University, Canada. Essentially it is a leaning methods based on the principle of using problems...

  2. Process modeling of comprehensive integrated forest biorefinery--an integrated approach.

    Science.gov (United States)

    Huang, Hua-Jiang; Lin, Weilu; Ramaswamy, Shri; Tschirner, Ulrike

    2009-05-01

    The key to expanding the energy supply, increasing energy security, and reducing the dependency on foreign oil is to develop advanced technologies to efficiently transform our renewable bioresources into domestically produced bioenergy and bioproducts. Conventional biorefineries, i.e., forest products industry's pulp and paper mills with long history of sustainable utilization of lignocellulose (wood), offer a suitable platform for being expanded into future integrated forest biorefineries. Due to the pre-existing infrastructure in current forest products operations, this could present a very cost-effective approach to future biorefineries. In order to better understand the overall process, technical, economic, and environmental impacts, a detailed process modeling of the whole integrated forest biorefinery is presented here. This approach uses a combination of Aspen Plus, WinGEMS, and Microsoft Excel to simulate the entire biorefinery in detail with sophisticated communication interface between the three simulations. Preliminary results for a simple case study of an integrated biorefinery show the feasibility of this approach. Further investigations, including additional details, more process options, and complete integration, are currently underway.

  3. FT. Sam 91 Whiskey Combat Medic Medical Simulation Training Quantitative Integration Enhancement Program

    Science.gov (United States)

    2011-07-01

    the number of predefined clinical steps performed and the completion times recorded for each of the procedural skills examined in this study. The...emergency medical care to patrons of large events such as concerts, NBA basketball games, Conventions and many other events in San Antonio. (Contact...SEMESTER HOURS RECORDED Military 71.00 Civilian 28.00 Exam 6.00 All Sources 105.00 REFERENCES Ian Coon USAF MSgt Phone Number: (210)262-9422

  4. Making Whole: Applying the Principles of Integrative Medicine to Medical Education.

    Science.gov (United States)

    Chow, Grace; Liou, Kevin T; Heffron, Robert C

    2016-03-01

    In the past few decades, the public's use of complementary and alternative medicine (CAM) has steadily increased. The term "integrative medicine" is often used to refer to the combination of CAM with conventional medicine. Many medical schools have incorporated didactic content on CAM and/or integrative medicine into their curricula. A frequently cited rationale for these course offerings is that medical students ought to be taught the basics of CAM in order to counsel patients on safe, effective therapeutic options. Schools have also offered these courses to meet the needs of students who are interested in incorporating CAM into future practices. In this article, the authors suggest that the core principles of integrative medicine--holistic worldview, centrality of the doctor-patient relationship, emphasis on wellness, and inclusiveness--are aligned with the goals of contemporary medical education and serve a critical function in the development of effective, humanistic physicians.

  5. The integration of a telemental health service into rural primary medical care.

    Science.gov (United States)

    Davis, G L; Boulger, J G; Hovland, J C; Hoven, N T

    2007-07-01

    Mental health care shortages in rural areas have resulted in the majority of services being offered through primary medical care settings. The authors argue that a paradigm shift must occur so that those in need of mental health care have reasonable, timely access to these services. Changes proposed include integrating mental health services into primary medical care settings, moving away from the traditional view of mental health care services (one therapist, one hour, and one client), and increasing the consultative role of psychologists and other mental health care providers in primary medical care. Characteristics of mental health providers that facilitate effective integration into primary medical care are presented. The results of a needs assessment survey and an example of a telemental health project are described. This project involved brief consultations with patients and their physicians from a shared care model using a broadband internet telecommunications link between a rural clinic and mental health service providers in an urban area.

  6. Identifying medication error chains from critical incident reports: a new analytic approach.

    Science.gov (United States)

    Huckels-Baumgart, Saskia; Manser, Tanja

    2014-10-01

    Research into the distribution of medication errors usually focuses on isolated stages within the medication use process. Our study aimed to provide a novel process-oriented approach to medication incident analysis focusing on medication error chains. Our study was conducted across a 900-bed teaching hospital in Switzerland. All reported 1,591 medication errors 2009-2012 were categorized using the Medication Error Index NCC MERP and the WHO Classification for Patient Safety Methodology. In order to identify medication error chains, each reported medication incident was allocated to the relevant stage of the hospital medication use process. Only 25.8% of the reported medication errors were detected before they propagated through the medication use process. The majority of medication errors (74.2%) formed an error chain encompassing two or more stages. The most frequent error chain comprised preparation up to and including medication administration (45.2%). "Non-consideration of documentation/prescribing" during the drug preparation was the most frequent contributor for "wrong dose" during the administration of medication. Medication error chains provide important insights for detecting and stopping medication errors before they reach the patient. Existing and new safety barriers need to be extended to interrupt error chains and to improve patient safety.

  7. Hedging Medical Spending Growth: An Adaptive Expectations Approach.

    Science.gov (United States)

    Lieberthal, Robert D

    2016-08-01

    Long-term health insurance provides consumers with protection against persistent, negative health shocks. While the stochastic rise in medical spending growth may make some health risks harder to insure, financial assets could act as a hedge for medical spending growth risk. The purpose of this research was to determine whether such hedges exist. The results of this study were two-fold. First, the asset classes with the strongest statistical evidence as hedges were bonds, not stocks. Second, any strategy to hedge medical spending growth involved shorting assets i.e. betting against the bond or stock market. Health insurers writing long-term contracts should combine the use of hedges in the bond market with of portfolio diversification, and may benefit from health policies to moderate the uncertainty of medical spending growth.

  8. An Approach to Establishing International Quality Standards for Medical Travel

    Directory of Open Access Journals (Sweden)

    Ondřej eKácha

    2016-03-01

    Full Text Available Traveling abroad to receive a non-elective treatment is expanding each year. Such rising popularity of medical travel and the absence of clear minimum quality requirements in this area urgently calls for setting international standards to ensure good practice and patient safety. The aim of this study is to identify the key domains in medical travel where such quality standards should be established. Drawing from the evidence-based OECD framework and an extensive literature review, this study proposes three critical areas for international quality standards in medical travel: minimum standards of health care facilities and third-party agencies, financial responsibility and patient-centeredness. Several cultural challenges are subsequently introduced that may pose a barrier to the development of the guidelines and should be additionally taken into consideration. Establishing international quality standards in medical travel enhances the benefits to patients and providers, which is urgently needed given the rapid growth in this industry.

  9. Systematic Approach to Better Understanding Integration Costs: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Stark, Gregory B.

    2015-09-28

    When someone mentions integration costs, thoughts of the costs of integrating renewable generation into an existing system come to mind. We think about how variability and uncertainty can increase power system cycling costs as increasing amounts of wind or solar generation are incorporated into the generation mix. However, seldom do we think about what happens to system costs when new baseload generation is added to an existing system or when generation self-schedules. What happens when a highly flexible combined-cycle plant is added? Do system costs go up, or do they go down? Are other, non-cycling, maintenance costs impacted? In this paper we investigate six technologies and operating practices--including VG, baseload generation, generation mix, gas prices, self-scheduling, and fast-start generation--and how changes in these areas can impact a system's operating costs. This paper provides a working definition of integration costs and four components of variable costs. It describes the study approach and how a production cost modeling-based method was used to determine the cost effects, and, as a part of the study approach section, it describes the test system and data used for the comparisons. Finally, it presents the research findings, and, in closing, suggests three areas for future work.

  10. Integrated Academic Information Management Systems (IAIMS). Part III. Implementation of integrated information services. Medical informatics education.

    Science.gov (United States)

    Zimmerman, J L; van Bemmel, J H; Rienhoff, O

    1988-03-01

    Medical informatics is still in its early stages of evolution and definition. If informatics is to obtain the status of a specialized field of study within the health science curriculum, its ambiguity must be eliminated. This article discusses the term "medical informatics" and the impact of the new field of study on curriculum, education, and training of health care professionals, and health care information systems research and development.

  11. Clinical capabilities of graduates of an outcomes-based integrated medical program

    Directory of Open Access Journals (Sweden)

    Scicluna Helen A

    2012-06-01

    Full Text Available Abstract Background The University of New South Wales (UNSW Faculty of Medicine replaced its old content-based curriculum with an innovative new 6-year undergraduate entry outcomes-based integrated program in 2004. This paper is an initial evaluation of the perceived and assessed clinical capabilities of recent graduates of the new outcomes-based integrated medical program compared to benchmarks from traditional content-based or process-based programs. Method Self-perceived capability in a range of clinical tasks and assessment of medical education as preparation for hospital practice were evaluated in recent graduates after 3 months working as junior doctors. Responses of the 2009 graduates of the UNSW’s new outcomes-based integrated medical education program were compared to those of the 2007 graduates of UNSW’s previous content-based program, to published data from other Australian medical schools, and to hospital-based supervisor evaluations of their clinical competence. Results Three months into internship, graduates from UNSW’s new outcomes-based integrated program rated themselves to have good clinical and procedural skills, with ratings that indicated significantly greater capability than graduates of the previous UNSW content-based program. New program graduates rated themselves significantly more prepared for hospital practice in the confidence (reflective practice, prevention (social aspects of health, interpersonal skills (communication, and collaboration (teamwork subscales than old program students, and significantly better or equivalent to published benchmarks of graduates from other Australian medical schools. Clinical supervisors rated new program graduates highly capable for teamwork, reflective practice and communication. Conclusions Medical students from an outcomes-based integrated program graduate with excellent self-rated and supervisor-evaluated capabilities in a range of clinically-relevant outcomes. The program

  12. Holistic Approach for Teaching Tuberculosis in Medical Education

    Directory of Open Access Journals (Sweden)

    Saurabh RamBihariLal Shrivastava

    2014-05-01

    Full Text Available Tuberculosis (TB is the foremost cause of mortality attributed to a curable infectious disease globally, accounting for 8.6 million new cases in the year 2012, of which India alone has a share of almost 25% of cases. Medical colleges have been acknowledged as tertiary level health care centers and have a key role in the diagnosis and management of different types of TB cases. However, a wide range of barriers and deficiencies have been acknowledged in the medical education curriculum over a period of time with regard to teaching of TB control. To combat the magnitude of TB on the health sector in Indian set-up, there is a crucial need for establishing a mutual and complementary partnership between policy makers, delegates from the medical colleges, and the regulatory body for medical education. In summary, medical students are the future health care providers for the general population and thus a well-organized medical education curriculum can play a significant role in reducing the magnitude of tuberculosis in the coming decade.

  13. Learning approaches to physiology of undergraduates in an Indian medical school.

    Science.gov (United States)

    Abraham, Reem R; Kamath, Asha; Upadhya, Subramanya; Ramnarayan, Komattil

    2006-09-01

    Inventories monitoring students' learning approaches are widely used in medical education research. It is important that teaching interventions adopted in medical schools aim to develop a deep approach to learning in medical students. To study the changes in medical students' approaches to learning before and after the incorporation of clinically orientated physiology teaching (COPT) in the undergraduate physiology curriculum, using the Short Inventory of Approaches to Learning (SIAL). Medical students (n = 223) at Melaka Manipal Medical College (Manipal Campus) undertake a 9-week learning block of endocrine, reproductive and renal physiology in Year 1. During this period, COPT was incorporated along with regular didactic lectures with the intention of enhancing the use of the deep approach and decreasing the use of the surface and strategic approaches to learning taken by the students. The SIAL, which focuses on the learning approaches of students to physiology, was distributed both before and after COPT. The implementation of COPT seemed to affect the learning approaches of students as measured by the SIAL. After the introduction of COPT, there was a significant increase in the use of the deep learning approach, while the majority of subscales for the surface approach showed decreased use. Nevertheless, use of the strategic approach was found to have increased after COPT. The SIAL was found to be a fairly reliable tool with which to determine the learning approaches of medical students. Clinically orientated physiology teaching was successful in enhancing use of the deep approach to learning and reducing use of the surface approach among undergraduate medical students.

  14. The Theory of Bio-Medical Knowledge Integration(Ⅷ)——The Intrinsic Medical Informatics(IMI) and Meta-dimensions(MDs) of SNOMED

    Institute of Scientific and Technical Information of China (English)

    BAO Han-fei

    2008-01-01

    This paper presented the profile of Intrinsic Medical Informatics(IMI), which consists of Medical Cognition Informatics(MCI) and Organism Informatics (OI). MCI and OI are taken as two cornerstones of the Theory of BioMedical Knowledge Integration(BMKI). Additionally, so called Meta-dimension architecture of SNOMED is discussed in order to venture its context computing.

  15. Necessity and approach to integrated nanomaterial legislation and governance.

    Science.gov (United States)

    Wang, Jiafan; Gerlach, John D; Savage, Nora; Cobb, George P

    2013-01-01

    Nanotechnology is one of the most promising technologies to emerge in recent decades. Materials that are specially engineered to have at least one dimension that is no larger than 100 nm are now continuously manufactured and incorporated as critical components of different products that people use daily. While we are taking advantage of nanomaterials (NMs) and nano-products, they may pose a risk to humans and the broader environment. Some types of fibrous NMs such as carbon nanotubes and nano-fibers may present a risk similar to that of asbestos. Some carbon or metal based NMs may threaten the environment due to their bioaccumulative nature within food webs. In order to prevent future adverse effects from products or byproducts of nanotechnology, we suggest an integrated multi-faceted approach which includes an integrated regulation that is based upon life cycle assessment, empirically derived risk assessment. Advanced research that fills the knowledge gap regarding the understanding of NMs in scientific and social norms will be helpful in a full life cycle assessment of NMs. Emphasizing nanotechnology education to the public for an increased understanding and participation associated with media coverage will finally draw governments' attention with an integrated legislation to be instituted. Developing the optimal mix of these tools, including research, public education, media coverage, integrated legislation, will be significant to proactively manage the complexity of nanotechnology and prevent any undesirable effect due to the NMs exposure.

  16. A liberation psychology approach to acculturative integration of migrant populations.

    Science.gov (United States)

    García-Ramírez, Manuel; de la Mata, Manuel L; Paloma, Virginia; Hernández-Plaza, Sonia

    2011-03-01

    This paper describes an acculturative integration approach that stresses the contribution of liberation psychology. Immigrant integration is a challenge for receiving countries in the Western world due to the frequent asymmetrical and oppressive conditions suffered by newcomers in their new settlements. The cross-cultural perspective connects integration with psychological acculturation, emphasizing harmony between acquisitions of the new culture while maintaining cultural heritage, and creating opportunities for intergroup relationships. In turn, liberation psychology permits an understanding of the acculturative transition as an empowerment and self-construction process by which immigrants acquire a new vision of the world and of themselves, transforming both structural conditions and themselves. From this perspective we conceptualize acculturative integration as the process by which newcomers become an accepted part of the new society through a reflexive and evaluative process, changing their social references and position, rebuilding their social and personal resources, and achieving a new agency in coherence with their new challenges and goals. In this process, they acquire critical thinking about unequal conditions, gain capacities to respond to the inequalities, and take effective actions to confront them. We illustrate this process using the narratives of nine Moroccan women who are living in asymmetrical and oppressive local contexts in Andalusia, the southern-most region of Spain.

  17. A learning collaborative of CMHCs and CHCs to support integration of behavioral health and general medical care.

    Science.gov (United States)

    Vannoy, Steven D; Mauer, Barbara; Kern, John; Girn, Kamaljeet; Ingoglia, Charles; Campbell, Jeannie; Galbreath, Laura; Unützer, Jürgen

    2011-07-01

    Integration of general medical and mental health services is a growing priority for safety-net providers. The authors describe a project that established a one-year learning collaborative focused on integration of services between community health centers (CHCs) and community mental health centers (CMHCs). Specific targets were treatment for general medical and psychiatric symptoms related to depression, bipolar disorder, alcohol use disorders, and metabolic syndrome. This observational study used mixed methods. Quantitative measures included 15 patient-level health indicators, practice self-assessment of resources and support for chronic disease self-management, and participant satisfaction. Sixteen CHC-CMHC pairs were selected for the learning collaborative series. One pair dropped out because of personnel turnover. All teams increased capacity on one or more patient health indicators. CHCs scored higher than CMHCs on support for chronic disease self-management. Participation in the learning collaborative increased self-assessment scores for CHCs and CMHCs. Participant satisfaction was high. Observations by faculty indicate that quality improvement challenges included tracking patient-level outcomes, workforce issues, and cross-agency communication. Even though numerous systemic barriers were encountered, the findings support existing literature indicating that the learning collaborative is a viable quality improvement approach for enhancing integration of general medical and mental health services between CHCs and CMHCs. Real-world implementation of evidence-based guidelines presents challenges often absent in research. Technical resources and support, a stable workforce with adequate training, and adequate opportunities for collaborator communications are particular challenges for integrating behavioral and general medical services across CHCs and CMHCs.

  18. A Sociology of Knowledge Approach to European Integration

    DEFF Research Database (Denmark)

    Adler-Nissen, Rebecca; Kropp, Kristoffer

    2015-01-01

    Scholars are deeply involved in the process of European integration, but we lack systematic understanding of this involvement. On the one hand, scholars, academic ideas and ideologies shape European integration and policies (e.g. the Economic and Monetary Union and the free movement of people...... and Technology Studies (STS) and political sociology, this introductory article develops a framework for studying the entanglement of EU studies with the EU around four analytical principles: (1) the principle of symmetry, (2) the principle of rejecting the internal/external division, (3) the principle...... of situatedness and (4) the principle of contextualism. A sociology of knowledge approach provides alternative explanations of the EU’s development and of our scholarly attempts to make sense of it....

  19. CSR Integration into the Financial Economy: A Conceptual Approach

    Directory of Open Access Journals (Sweden)

    Georgiana - Loredana FRECEA

    2016-06-01

    Full Text Available Corporate social responsibility is a complex concept and its design integrates economic, social and environmental issues, pointing out the operational effects on a voluntary basis. It is considered a strategic point in the actual evolution of the economy, due to the financial market dynamism, being identified a critical correlation between financial crises and corporate social responsibility. The main purpose of this paper is to synthesize, through a literature review, the multiple dimensions of CSR, with a special emphasis on the theoretical approach. In order to provide a coherent overview on the banking CSR, it will be proposed a division of the CSR theories according to: (1 the ethical approach, (2 the stakeholders approach, and (3 the corporate governance approach. The major aim of this paper is to fill a gap in the theoretical approach of the CSR for the banking system, due to the necessity to unify the CSR reporting elements in order to find a balance between the bank’s organizational structure and their legitimacy to operate on the financial market.

  20. Medical provider attitudes about behavioral health consultants in integrated primary care: a preliminary study.

    Science.gov (United States)

    Torrence, Nicole D; Mueller, Anne E; Ilem, Allison A; Renn, Brenna N; DeSantis, Brian; Segal, Daniel L

    2014-12-01

    Integrated behavioral health increases service utilization and treatment success, particularly with high-risk populations. This study assessed medical personnel's attitudes and perceptions of behavioral health clinicians (BHCs) in primary care using a brief self-report measure. A 6-item survey was given to medical providers (n = 45) from a health care system that includes integrated behavioral health services. Survey items assessed providers' attitudes and perceptions about BHCs. Attitudes about behavioral health were largely favorable. For all items, 73.3% to 100% of participants endorsed strongly agree or agree. Chi-square analyses revealed that those who interacted more frequently with BHCs were more comfortable discussing behavioral health issues with their patients, χ²(6, n = 45) = 13.43, p providers worked were not significantly related to any survey items. Medical providers surveyed believe that BHCs are valuable members of integrated health care, improving their abilities to provide care and to address their patients' physical and behavioral health problems. Although these preliminary results are promising, the setting surveyed has well-integrated behavioral health care services and thus might not be representative of other settings without such integration. Future studies should address medical providers' opinions of BHCs in a variety of settings with larger samples.

  1. Perspectives on Medical Services Integration among Conventional Western, Traditional Korean, and Dual-Licensed Medical Doctors in Korea

    Directory of Open Access Journals (Sweden)

    Junghwa Lim

    2013-01-01

    Full Text Available The aim of this study was to examine the perspectives on the options for the integration of western and traditional Korean medical services among three types of medical doctors with different disciplines in Korea. We surveyed and analyzed responses from 167 conventional Western medicine (WM, 135 traditional Korean medicine (KM, and 103 dual-licensed (DL doctors who can practice both. All three kinds of doctors shared similar attitude toward license unitarization. KM doctors most strongly agreed on the need of the cooperative practice (CP between KM and WM and on the possibility of license unitarization among three groups. DL doctors believed that CP is currently impracticable and copractice is more efficient than CP. WM doctors presented the lowest agreement on the need of CP and showed lower expectation for DL doctors as mediators between WM and KM than others. This study showed the difference of perspectives on the options for the integrative medical services among three different doctor groups in Korea. More studies are required to explore the underlying reasons for these discrepancies among WM, KM, and DL doctors.

  2. Effect of an Integrated Case-based Nutrition Curriculum on Medical Education at Qazvin University of Medical Sciences, Iran

    Science.gov (United States)

    Afaghi, Ahmad; Mohamadi, Ali Akbar Haj Agha; Sarchami, Ramin; Ziaee, Amir

    2012-01-01

    Introduction: Nutrition education is identified as an important part of medical education by organizations. Qazvin University of Medical Sciences, school of medicine (QUMS SOM), has a required basic nutrition course of 36 hr in second year of medical school, but education experts reports show that the course does not provide required therapeutic skills for graduate student. Method: We decided to organize an 8-hr diet therapy work shop in order to develop a patient experience clinical based case study teaching to enhance clinical skills at QUMS SOM. Results: Students’ perception score about adequacy of nutrition instruction increased from 20% (at baseline) to 70% (after intervention). The mean nutrition knowledge score of total students in clinical nutrition were different between before and one month after integration (8.3±2.5, 13.4±3.2, P curriculum at QUMS was appropriate method to enhance student’s perception about nutrition integration and to increase and translate the knowledge to clinical practice. PMID:22980104

  3. Teaching pharmacology to medical students in an integrated problem-based learning curriculum:an Australian perspective

    Institute of Scientific and Technical Information of China (English)

    Owen L WOODMAN; Agnes E DODDS; Albert G FRAUMAN; Mosepele MOSEPELE

    2004-01-01

    The world-wide move away from the didactic teaching of single disciples to integrated Problem-based Learning (PBL) curricula in medical education has posed challenges for the basic sciences. In this paper we identify two major challenges. The first challenge is the need to describe a core disciplinary curriculum that can be articulated and mapped onto the new structure. We illustrate how the British Pharmacological Society (BPS) Guidelines are used to evaluate the curriculum coverage in the medical course at The University of Melbourne. The second challenge is to ensure that foundational concepts are given adequate emphasis within the new structure, and in particular, that students have the opportunity to pursue these concepts in their self-directed learning. We illustrate one approach to teaching important pharmacological concepts in an integrated curriculum with a case study from the first year curriculum at The University of Melbourne. Finally, we propose the features of an integrated curriculum that facilitates the learning of basic pharmacology in a situation where PBL and integration sets the curriculum framework.

  4. Criminal Rehabilitation Through Medical Intervention: Moral Liability and the Right to Bodily Integrity.

    Science.gov (United States)

    Douglas, Thomas

    2014-06-01

    Criminal offenders are sometimes required, by the institutions of criminal justice, to undergo medical interventions intended to promote rehabilitation. Ethical debate regarding this practice has largely proceeded on the assumption that medical interventions may only permissibly be administered to criminal offenders with their consent. In this article I challenge this assumption by suggesting that committing a crime might render one morally liable to certain forms of medical intervention. I then consider whether it is possible to respond persuasively to this challenge by invoking the right to bodily integrity. I argue that it is not.

  5. Integrated Medical Model (IMM) Project Verification, Validation, and Credibility (VVandC)

    Science.gov (United States)

    Walton, M.; Boley, L.; Keenan, L.; Kerstman, E.; Shah, R.; Young, M.; Saile, L.; Garcia, Y.; Meyers, J.; Reyes, D.

    2015-01-01

    The Integrated Medical Model (IMM) Project supports end user requests by employing the Integrated Medical Evidence Database (iMED) and IMM tools as well as subject matter expertise within the Project. The iMED houses data used by the IMM. The IMM is designed to forecast relative changes for a specified set of crew health and mission success risk metrics by using a probabilistic model based on historical data, cohort data, and subject matter expert opinion. A stochastic approach is taken because deterministic results would not appropriately reflect the uncertainty in the IMM inputs. Once the IMM was conceptualized, a plan was needed to rigorously assess input information, framework and code, and output results of the IMM, and ensure that end user requests and requirements were considered during all stages of model development and implementation, as well as lay the foundation for external review and application. METHODS: In 2008, the Project team developed a comprehensive verification and validation (VV) plan, which specified internal and external review criteria encompassing 1) verification of data and IMM structure to ensure proper implementation of the IMM, 2) several validation techniques to confirm that the simulation capability of the IMM appropriately represents occurrences and consequences of medical conditions during space missions, and 3) credibility processes to develop user confidence in the information derived from the IMM. When the NASA-STD-7009 (7009) [1] was published, the Project team updated their verification, validation, and credibility (VVC) project plan to meet 7009 requirements and include 7009 tools in reporting VVC status of the IMM. Construction of these tools included meeting documentation and evidence requirements sufficient to meet external review success criteria. RESULTS: IMM Project VVC updates are compiled recurrently and include updates to the 7009 Compliance and Credibility matrices. Reporting tools have evolved over the lifetime of

  6. [The shaping of ethical approach to medical experimentation in Poland].

    Science.gov (United States)

    Heimrath, Tadeusz

    2003-06-01

    Contemporary awareness of bioethical norms in treatment and research experiments in medicine underwent a long evolution in Poland. The process was similar to that of other countries developing this kind of research. The negative experiences of World War II resulted in tendency to curb experimentation on humans. The seventies witnessed a heated discussion leading to settlement of this problem. The argument was that stringent limitations on such experiments would stop the development of new, indispensable drugs. This discussion also reached Poland where the majority of participants were doctors and lawyers expressing their views mostly in the press. This led in consequence to the establishment of the first ethical norms in medical experiment on humans. These were expressed in subsequent codes of ethics for the medical profession as well as in the founding of the first bioethical commissions at medical schools. Currently such norms based on the so-called "good clinical practice" standards were incorporated in the legal acts that establish bioethical committees at medical schools and other medical institutes. This paper also presents some specific aspects of research on female patients.

  7. Integrated Medical Information Services: A Resource Management View of Automated Hospital Information Systems

    OpenAIRE

    Melrose, J. Peter; Ericson, R. Peter

    1981-01-01

    Rapid changes in information processing technology have made the problems of administrative and technical planning and integration difficult. Vendor-inspired terms such as “office of the future” have created confusion rather than clarification. However, the term “information resource management” (IRM) that has evolved in the private sector has potential merit. From the idea of IRM, the authors have developed the planning concept of Integrated Medical Information Services (IMIS) as a common ad...

  8. Integrative Approaches to Caring for Children with Autism.

    Science.gov (United States)

    Klein, Nadav; Kemper, Kathi J

    2016-06-01

    Parents commonly integrate complementary and alternative medical (CAM) treatments for autism spectrum disorder (ASD) with conventional care. The aims of this article are to (1) describe the most commonly used treatments, (2) assess their efficacy and safety, and (3) organize the information in practical format for practitioners. We organized treatment modalities into four categories: recommended, monitored, tolerated, and therapies that should be avoided. These four categories are based on a two by two table weighing a therapy׳s effectiveness and safety. To meet the threshold for "recommended," its effectiveness needed to be supported by two or more randomized, controlled trials. In addition to promoting an overall healthy lifestyle via nutrition, exercise, sleep, stress management, social support, and avoiding neurotoxins (healthy habits in a healthy habitat), the most promising therapies recommend are applied behavior analysis, parent-implemented training, melatonin supplements to improve sleep, supplements to correct deficiencies, and music therapy. Medications and restrictive diets may be helpful for some children, but use should be monitored given the risk of side effects. Most complementary therapies are safe, so they can be tolerated, but additional research is needed before they should be recommended. Given their risks, costs, and limited evidence of efficacy, chelation, secretin, and hyperbaric oxygen should be avoided. Copyright © 2016 Mosby, Inc. All rights reserved.

  9. Integrating Genetic Algorithm, Tabu Search Approach for Job Shop Scheduling

    CERN Document Server

    Thamilselvan, R

    2009-01-01

    This paper presents a new algorithm based on integrating Genetic Algorithms and Tabu Search methods to solve the Job Shop Scheduling problem. The idea of the proposed algorithm is derived from Genetic Algorithms. Most of the scheduling problems require either exponential time or space to generate an optimal answer. Job Shop scheduling (JSS) is the general scheduling problem and it is a NP-complete problem, but it is difficult to find the optimal solution. This paper applies Genetic Algorithms and Tabu Search for Job Shop Scheduling problem and compares the results obtained by each. With the implementation of our approach the JSS problems reaches optimal solution and minimize the makespan.

  10. A path integral approach to asset-liability management

    Science.gov (United States)

    Decamps, Marc; De Schepper, Ann; Goovaerts, Marc

    2006-05-01

    Functional integrals constitute a powerful tool in the investigation of financial models. In the recent econophysics literature, this technique was successfully used for the pricing of a number of derivative securities. In the present contribution, we introduce this approach to the field of asset-liability management. We work with a representation of cash flows by means of a two-dimensional delta-function perturbation, in the case of a Brownian model and a geometric Brownian model. We derive closed-form solutions for a finite horizon ALM policy. The results are numerically and graphically illustrated.

  11. Angina in a diabetic patient: a case of integrated approach

    Directory of Open Access Journals (Sweden)

    Eugenio Roberto Cosentino

    2008-09-01

    Full Text Available Diabetes mellitus, both of type 1 and 2, is an important risk factor for the development of atherosclerosis: in diabetic patients vascular atherosclerotic complications are responsible of approximately 80% of all the deaths. There is no doubt that patients affections originating from diabetes and coronaropathy remain at high risk. For this reason it is essential to adopt an aggressive strategy of secondary prevention. We report a case of a patient with multiple risk factors for cardiovascular diseases: the successful management was due to an integrated approach that involved the general practitioner and cardiologist.

  12. Integrated analytical approaches towards toxic algal natural products discovery

    DEFF Research Database (Denmark)

    Larsen, Thomas Ostenfeld; Rasmussen, Silas Anselm; Gedsted Andersen, Mikael

    demonstrated that phenotypic based chemotaxonomy can be successfully used as the intial step in selection of talented strains for testing in various bioassays, using multivariate methods for clustering of whole profiles of metabolites. The second and very important step in the discovery process...... the structures of already known compounds (3). When likely unknown compounds have been identified, we use E-SPE results (4) to predict a fast and optimal purification strategy towards the pure novel compounds for NMR characterization. This presentation will highlight our integrated analytical approaches...

  13. Integrated approach to yoga therapy and autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Shantha Radhakrishna

    2010-01-01

    Full Text Available A specially designed Integrated Approach to Yoga Therapy module was applied to Autism Spectrum Disorders over a period of two academic years. Despite low numbers (six in each arm, consistency and magnitude of effects make the findings significant. Parental participation, allowing firm guidance to be given to each child, resulted in significant improvements in imitation and other skills, and in behavior at home and family relationships. We hypothesize that guided imitation of therapist body positions stimulated mirror neuron activation, resulting in improved sense of self.

  14. An Approach to Establishing International Quality Standards for Medical Travel.

    Science.gov (United States)

    Kácha, Ondřej; Kovács, Beáta E; McCarthy, Cormac; Schuurmans, Angela A T; Dobyns, Christopher; Haller, Elisa; Hinrichs, Saba; Ruggeri, Kai

    2016-01-01

    The number of individuals traveling abroad is increasing annually. The rising popularity of medical travel and the absence of clear minimum quality requirements in this area urgently call for the development of international standards to ensure good practice and patient safety. The aim of this study is to identify the key domains in medical travel where quality standards should be established. Drawing from the evidence-based OECD framework and an extensive literature review, this study proposes three critical areas for consideration: minimum standards of health-care facilities and third-party agencies, financial responsibility, and patient centeredness. Several cultural challenges have been introduced that may pose a barrier to development of the guidelines and should be taken into consideration. Establishing international quality standards in medical travel enhances benefits to patients and providers, which is an urgent necessity given the rapid growth in this industry.

  15. Medical and agricultural entomology in Brazil: a historical approach.

    Science.gov (United States)

    Benchimol, J L

    2008-12-01

    Medical Entomology emerged in Brazil in the late nineteenth century, through the initiative of a group of physicians dedicated to researching microorganisms related to diseases of public health importance, especially yellow fever and malaria. They led the institutionalization of Bacteriology and Tropical Medicine in southeast Brazil and the sanitation of coastal cities and, subsequently, rural areas. Medical Entomology provided the professionals who would undertake campaigns against agricultural plagues, as well as the institutionalization of Agronomy and Veterinary Medicine. In the present article, I intend to show how relations between the professionals who gave life to Medical Entomology in Brazil were interwoven and to illustrate their relations with entomologists in other countries. I will also present an overview of the research problems faced by Brazilian entomologists at the turn of the nineteenth century and early decades of the twentieth.

  16. Introducing integrated teaching and comparison with traditional teaching in undergraduate medical curriculum: A pilot study

    Directory of Open Access Journals (Sweden)

    Mausumi Basu

    2015-01-01

    Full Text Available Background: Medical colleges in India usually follow a traditional curriculum, characterized by "discipline wise model" which compelled Medical Council of India to recommend a teaching approach characterized by maximal efforts to encourage integrated teaching (IT between traditional subject areas. Objectives: To assess the feasibility of IT; to compare IT with traditional teaching (TT and to analyze the student′s feedback and faculty feedback about perception of IT. Materials and Methods: An interventional study was conducted among fifth semester students using pre- and post-test questionnaire and student and faculty feedback forms. Students were divided randomly into two groups. IT was introduced to Group I on the topic of tuberculosis (TB by faculties of different disciplines; using methods of didactic lectures, seminars, role play, clinical case presentation, demonstration of Ziehl-Neelsen stain, Bacillus Calmette-Guerin vaccination and visit to Directly Observed Treatment Centre. Group II were exposed to TT on TB by faculties of Community Medicine using method of didactic lectures. Paired and un-paired t-test and effect size were used as statistical tests. Results : Statistically significant results were obtained using pre- and post-test questionnaire of IT. Similarly, statistically significant results were obtained using posttest results of IT and TT. Effect size that is: Cohen′s d and Pearson correlation revealed large effect which indicates high influence on student achievement. The students and faculty showed a positive attitude about IT. Conclusion: The introduction of IT was found to be feasible and to be more effective and acceptable than TT.

  17. [Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

    Science.gov (United States)

    Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

    2010-04-01

    To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.

  18. A design approach for integrating thermoelectric devices using topology optimization

    DEFF Research Database (Denmark)

    Soprani, Stefano; Haertel, Jan Hendrik Klaas; Lazarov, Boyan Stefanov;

    2016-01-01

    to operate more efficiently. This work proposes and experimentally demonstrates a topology optimization approach as a design tool for efficient integration of thermoelectric modules into systems with specific design constraints. The approach allows thermal layout optimization of thermoelectric systems....... The design method incorporates temperature dependent properties of the thermoelectric device and other materials. The3D topology optimization model developed in this work was used to design a thermoelectric system, complete with insulation and heat sink, that was produced and tested. Good agreement between...... experimental results and model forecasts was obtained and the system was able to maintain the load at more than 33 K below the oil well temperature. Results of this study support topology optimizationas a powerful design tool for thermal design of thermoelectric systems....

  19. Advanced multiresponse process optimisation an intelligent and integrated approach

    CERN Document Server

    Šibalija, Tatjana V

    2016-01-01

    This book presents an intelligent, integrated, problem-independent method for multiresponse process optimization. In contrast to traditional approaches, the idea of this method is to provide a unique model for the optimization of various processes, without imposition of assumptions relating to the type of process, the type and number of process parameters and responses, or interdependences among them. The presented method for experimental design of processes with multiple correlated responses is composed of three modules: an expert system that selects the experimental plan based on the orthogonal arrays; the factor effects approach, which performs processing of experimental data based on Taguchi’s quality loss function and multivariate statistical methods; and process modeling and optimization based on artificial neural networks and metaheuristic optimization algorithms. The implementation is demonstrated using four case studies relating to high-tech industries and advanced, non-conventional processes.

  20. An integrated turbocharger design approach to improve engine performance

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Turbocharging technology is today considered as a promising way for internal combustion engine energy saving and CO2 reduction.Turbocharger design is a major challenge for turbocharged engine performance improvement.The turbocharger designer must draw upon the information of engine operation conditions,and an appropriate link between the engine requirements and design features must be carefully developed to generate the most suitable design recommendation.The objective of this research is to develop a turbocharger design approach for better turbocharger matching to an internal combustion engine.The development of the approach is based on the concept of turbocharger design and interaction links between engine cycle requirements and design parameter values.A turbocharger through flow model is then used to generate the design alternatives.This integrated method has been applied with success to a gasoline engine turbocharger assembly.

  1. An Integrated Approach to Anti-Cancer Drug Sensitivity Prediction.

    Science.gov (United States)

    Berlow, Noah; Haider, Saad; Wan, Qian; Geltzeiler, Mathew; Davis, Lara E; Keller, Charles; Pal, Ranadip

    2014-01-01

    A framework for design of personalized cancer therapy requires the ability to predict the sensitivity of a tumor to anticancer drugs. The predictive modeling of tumor sensitivity to anti-cancer drugs has primarily focused on generating functions that map gene expressions and genetic mutation profiles to drug sensitivity. In this paper, we present a new approach for drug sensitivity prediction and combination therapy design based on integrated functional and genomic characterizations. The modeling approach when applied to data from the Cancer Cell Line Encyclopedia shows a significant gain in prediction accuracy as compared to elastic net and random forest techniques based on genomic characterizations. Utilizing a Mouse Embryonal Rhabdomyosarcoma cell culture and a drug screen of 60 targeted drugs, we show that predictive modeling based on functional data alone can also produce high accuracy predictions. The framework also allows us to generate personalized tumor proliferation circuits to gain further insights on the individualized biological pathway.

  2. Integrated Approach to Reconstruction of Microbial Regulatory Networks

    Energy Technology Data Exchange (ETDEWEB)

    Rodionov, Dmitry A [Sanford-Burnham Medical Research Institute; Novichkov, Pavel S [Lawrence Berkeley National Laboratory

    2013-11-04

    This project had the goal(s) of development of integrated bioinformatics platform for genome-scale inference and visualization of transcriptional regulatory networks (TRNs) in bacterial genomes. The work was done in Sanford-Burnham Medical Research Institute (SBMRI, P.I. D.A. Rodionov) and Lawrence Berkeley National Laboratory (LBNL, co-P.I. P.S. Novichkov). The developed computational resources include: (1) RegPredict web-platform for TRN inference and regulon reconstruction in microbial genomes, and (2) RegPrecise database for collection, visualization and comparative analysis of transcriptional regulons reconstructed by comparative genomics. These analytical resources were selected as key components in the DOE Systems Biology KnowledgeBase (SBKB). The high-quality data accumulated in RegPrecise will provide essential datasets of reference regulons in diverse microbes to enable automatic reconstruction of draft TRNs in newly sequenced genomes. We outline our progress toward the three aims of this grant proposal, which were: Develop integrated platform for genome-scale regulon reconstruction; Infer regulatory annotations in several groups of bacteria and building of reference collections of microbial regulons; and Develop KnowledgeBase on microbial transcriptional regulation.

  3. Auditory-Verbal Music Play Therapy: An Integrated Approach (AVMPT

    Directory of Open Access Journals (Sweden)

    Sahar Mohammad Esmaeilzadeh

    2013-10-01

    Full Text Available Introduction: Hearing loss occurs when there is a problem with one or more parts of the ear or ears and causes children to have a delay in the language-learning process. Hearing loss affects children's lives and their development. Several approaches have been developed over recent decades to help hearing-impaired children develop language skills. Auditory-verbal therapy (AVT is one such approach. Recently, researchers have found that music and play have a considerable effect on the communication skills of children, leading to the development of music therapy (MT and play therapy (PT. There have been several studies which focus on the impact of music on hearing-impaired children. The aim of this article is to review studies conducted in AVT, MT, and PT and their efficacy in hearing-impaired children. Furthermore, the authors aim to introduce an integrated approach of AVT, MT, and PT which facilitates language and communication skills in hearing-impaired children.   Materials and Methods: In this article we review studies of AVT, MT, and PT and their impact on hearing-impaired children. To achieve this goal, we searched databases and journals including Elsevier, Chor Teach, and Military Psychology, for example. We also used reliable websites such as American Choral Directors Association and Joint Committee on Infant Hearing websites. The websites were reviewed and key words in this article used to find appropriate references. Those articles which are related to ours in content were selected.    Results: Recent technologies have brought about great advancement in the field of hearing disorders. Now these impairments can be detected at birth, and in the majority of cases, hearing impaired children can develop fluent spoken language through audition. According to researches on the relationship between hearing impaired children’s communication and language skills and different approaches of therapy, it is known that learning through listening and

  4. An integrated Boltzmann+hydrodynamics approach to heavy ion collisions

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, Hannah

    2009-04-22

    In this thesis the first fully integrated Boltzmann+hydrodynamics approach to relativistic heavy ion reactions has been developed. After a short introduction that motivates the study of heavy ion reactions as the tool to get insights about the QCD phase diagram, the most important theoretical approaches to describe the system are reviewed. The hadron-string transport approach that this work is based on is the Ultra-relativistic Quantum Molecular Dynamics (UrQMD) approach. Predictions for the charged particle multiplicities at LHC energies are made. The next step is the development of a new framework to calculate the baryon number density in a transport approach. Time evolutions of the net baryon number and the quark density have been calculated at AGS, SPS and RHIC energies. Studies of phase diagram trajectories using hydrodynamics are performed. The hybrid approach that has been developed as the main part of this thesis is based on the UrQMD transport approach with an intermediate hydrodynamical evolution for the hot and dense stage of the collision. The full (3+1) dimensional ideal relativistic one fluid dynamics evolution is solved using the SHASTA algorithm. Three different equations of state have been used, namely a hadron gas equation of state without a QGP phase transition, a chiral EoS and a bag model EoS including a strong first order phase transition. For the freeze-out transition from hydrodynamics to the cascade calculation two different set-ups are employed. The parameter dependences of the model are investigated and the time evolution of different quantities is explored. The hybrid model calculation is able to reproduce the experimentally measured integrated as well as transverse momentum dependent v{sub 2} values for charged particles. The multiplicity and mean transverse mass excitation function is calculated for pions, protons and kaons in the energy range from E{sub lab}=2-160 A GeV. The HBT correlation of the negatively charged pion source

  5. Ayurveda education: Evaluating the integrative approaches of teaching Kriya Sharira (Ayurveda physiology

    Directory of Open Access Journals (Sweden)

    Himanshu Joshi

    2013-01-01

    Full Text Available Background: ′What is the ideal way of teaching Ayurveda?′ - has been a debated question since long. The present graduate level curriculum lists out the topics from ′contemporary medical science′ and ′Ayurveda′ discretely, placing no emphasis on integration. Most of the textbooks, too, follow the same pattern. This makes learning not only difficult, but also leads to cognitive dissonance. Objectives: To develop and evaluate the effectiveness of a few integrative teaching methods. Materials and Methods: We introduced three different interventions in the subject Kriya Sharira with special reference to ′cardiovascular physiology′. The instructional methods that we evaluated were: 1. Integrative module on cardiovascular physiology (IMCP, 2. case-stimulated learning (CSL, and 3. classroom small group discussion (CSGD. In the first two experiments, we subjected the experimental group of graduate students to the integrative instructional methods. The control group of students received the instructions in a conventional, didactic, teacher-centric way. After the experiments were over, the learning outcome was assessed and compared on the basis of the test scores. The groups were crossed over thereafter and the instructional methods were interchanged. Finally, feedback was obtained on different questionnaires. In the third experiment, only student feedback was taken as we could not have a control group. Results: The test results in the first experiment showed that the integrative method is comparable with the conventional method. In the second experiment, the test results showed that the integrative method is better than the conventional method. The student feedback showed that all the three methods were perceived to be more interesting than the conventional one. Conclusion: The study shows that the development of testable integrative teaching methods is possible in the context of Ayurveda education. It also shows that students find

  6. Integrated modular teaching in dermatology for undergraduate students: A novel approach

    Directory of Open Access Journals (Sweden)

    Kaliaperumal Karthikeyan

    2014-01-01

    Full Text Available Context: Undergraduate teaching in dermatology comprises didactic lectures and clinical classes. Integrated modular teaching is a novel approach, which integrates basic sciences with dermatology in the form of a module. Further the module also incorporates various teaching modalities, which facilitate active participation from students and promotes learning. The pre- and post-test values showed the effectiveness of the integrated module. The students feedback was encouraging. Aims: The aim of this study was to determine the acceptance and opinion of undergraduate students regarding integrated modular teaching as a new teaching aid in dermatology. Settings and Design: This was a descriptive study. Varied teaching methodologies involving multiple disciplines were undertaken in six major undergraduate topics in dermatology for seventh and eighth semester students. Materials and Methods: A total of six modules were conducted over a period of 12 months for students of seventh and eighth semesters. The topics for the various modules were sexually transmitted diseases, acquired immunodeficiency syndrome, oral ulcers, leprosy, connective tissue disorders and psoriasis. Faculty members from different disciplines participated. Pre- and post-test were conducted before and after the modules respectively to gauge the effectiveness of the modules. Results: It was found that almost every student had a better score on the posttest as compared to the pretest. General feedback obtained from the students showed that all of them felt that modular teaching was a more interesting and useful teaching learning experience than conventional teaching. Conclusions: Integrated modular teaching can be an effective adjunct in imparting theoretical and practical knowledge to the students. Further, various teaching methodologies can be used in integrated modules effectively with active student participation. Thus integrated modular teaching addresses two important issues in

  7. Ayurveda education: Evaluating the integrative approaches of teaching Kriya Sharira (Ayurveda physiology).

    Science.gov (United States)

    Joshi, Himanshu; Singh, Girish; Patwardhan, Kishor

    2013-07-01

    'What is the ideal way of teaching Ayurveda?' - has been a debated question since long. The present graduate level curriculum lists out the topics from 'contemporary medical science' and 'Ayurveda' discretely, placing no emphasis on integration. Most of the textbooks, too, follow the same pattern. This makes learning not only difficult, but also leads to cognitive dissonance. To develop and evaluate the effectiveness of a few integrative teaching methods. We introduced three different interventions in the subject Kriya Sharira with special reference to 'cardiovascular physiology'. The instructional methods that we evaluated were: 1. Integrative module on cardiovascular physiology (IMCP), 2. case-stimulated learning (CSL), and 3. classroom small group discussion (CSGD). In the first two experiments, we subjected the experimental group of graduate students to the integrative instructional methods. The control group of students received the instructions in a conventional, didactic, teacher-centric way. After the experiments were over, the learning outcome was assessed and compared on the basis of the test scores. The groups were crossed over thereafter and the instructional methods were interchanged. Finally, feedback was obtained on different questionnaires. In the third experiment, only student feedback was taken as we could not have a control group. The test results in the first experiment showed that the integrative method is comparable with the conventional method. In the second experiment, the test results showed that the integrative method is better than the conventional method. The student feedback showed that all the three methods were perceived to be more interesting than the conventional one. The study shows that the development of testable integrative teaching methods is possible in the context of Ayurveda education. It also shows that students find integrative approaches more interesting than the conventional method.

  8. Integrated modular teaching in dermatology for undergraduate students: A novel approach.

    Science.gov (United States)

    Karthikeyan, Kaliaperumal; Kumar, Annapurna

    2014-07-01

    Undergraduate teaching in dermatology comprises didactic lectures and clinical classes. Integrated modular teaching is a novel approach, which integrates basic sciences with dermatology in the form of a module. Further the module also incorporates various teaching modalities, which facilitate active participation from students and promotes learning. The pre- and post-test values showed the effectiveness of the integrated module. The students feedback was encouraging. The aim of this study was to determine the acceptance and opinion of undergraduate students regarding integrated modular teaching as a new teaching aid in dermatology. This was a descriptive study. Varied teaching methodologies involving multiple disciplines were undertaken in six major undergraduate topics in dermatology for seventh and eighth semester students. A total of six modules were conducted over a period of 12 months for students of seventh and eighth semesters. The topics for the various modules were sexually transmitted diseases, acquired immunodeficiency syndrome, oral ulcers, leprosy, connective tissue disorders and psoriasis. Faculty members from different disciplines participated. Pre- and post-test were conducted before and after the modules respectively to gauge the effectiveness of the modules. It was found that almost every student had a better score on the posttest as compared to the pretest. General feedback obtained from the students showed that all of them felt that modular teaching was a more interesting and useful teaching learning experience than conventional teaching. Integrated modular teaching can be an effective adjunct in imparting theoretical and practical knowledge to the students. Further, various teaching methodologies can be used in integrated modules effectively with active student participation. Thus integrated modular teaching addresses two important issues in medical education, namely integration and active student participation.

  9. Validity of Oxygen-Ozone Therapy as Integrated Medication Form in Chronic Inflammatory Diseases.

    Science.gov (United States)

    Bocci, Velio; Zanardia, Iacopo; Valacchi, Giuseppe; Borrelli, Emma; Travagli, Valter

    2015-01-01

    The state-of-the-art of oxygen-ozone therapy is now clarified and all the mechanisms of action of medical ozone are within classical biochemistry and molecular biology. The outcomes of standard treatments in peripheral arterial occlusive disease (PAOD) and dry-form of age-related macular degeneration (AMD) have been compared with the documented therapeutic results achieved with ozonated autohemotherapy (O-AHT). On the other hand, the clinical data of O-AHT on stroke remain indicative. As the cost of O-AHT is almost irrelevant, its application in all public hospitals, especially those of poor Countries, would allow two advantages: the first is for the patient, who will improve her/his conditions, and the second is for Health Authorities burdened with increasing costs. The aim of this paper is to report to clinical scientists that O-AHT is a scientific-based therapeutic approach without side effects. The integration of O-AHT with effective approved drugs is likely to yield the best clinical results in several chronic inflammatory diseases.

  10. Clinical Assessment of Risk Management: an INtegrated Approach (CARMINA).

    Science.gov (United States)

    Tricarico, Pierfrancesco; Tardivo, Stefano; Sotgiu, Giovanni; Moretti, Francesca; Poletti, Piera; Fiore, Alberto; Monturano, Massimo; Mura, Ida; Privitera, Gaetano; Brusaferro, Silvio

    2016-08-08

    Purpose - The European Union recommendations for patient safety calls for shared clinical risk management (CRM) safety standards able to guide organizations in CRM implementation. The purpose of this paper is to develop a self-evaluation tool to measure healthcare organization performance on CRM and guide improvements over time. Design/methodology/approach - A multi-step approach was implemented including: a systematic literature review; consensus meetings with an expert panel from eight Italian leader organizations to get to an agreement on the first version; field testing to test instrument feasibility and flexibility; Delphi strategy with a second expert panel for content validation and balanced scoring system development. Findings - The self-assessment tool - Clinical Assessment of Risk Management: an INtegrated Approach includes seven areas (governance, communication, knowledge and skills, safe environment, care processes, adverse event management, learning from experience) and 52 standards. Each standard is evaluated according to four performance levels: minimum; monitoring; outcomes; and improvement actions, which resulted in a feasible, flexible and valid instrument to be used throughout different organizations. Practical implications - This tool allows practitioners to assess their CRM activities compared to minimum levels, monitor performance, benchmarking with other institutions and spreading results to different stakeholders. Originality/value - The multi-step approach allowed us to identify core minimum CRM levels in a field where no consensus has been reached. Most standards may be easily adopted in other countries.

  11. Factors Affecting Medical Services Utilization: A Behavioral Approach.

    Science.gov (United States)

    Kelly, Terence F.; Schieber, George J.

    This study describes behavioral response--both its theoretical specification and its estimation--which relates health service utilization and expenditures to a number of variables: demographic, psychological, economic, medical, and policy-related. By incorporating these behavioral relations into a recently developed microsimulation model, national…

  12. A Rhetorical Approach to Understanding the Medical Interview.

    Science.gov (United States)

    Sharf, Barbara F.

    After discussing the rhetorical nature of physician/patient interactions, this paper describes and analyzes six medical interviews to illustrate the evolution of interpersonal and role relationships between physicians and patients, the sorts of information that are shared, and the way problems are resolved. The interviews that are described…

  13. Practical approaches to family-friendly medical studies.

    Science.gov (United States)

    Liebhardt, Hubert; Niehues, Johanna; Fegert, Jörg M

    2012-01-01

    Based on the pilot study carried out by the Office of the Dean of the Medical University of Ulm on the family-friendliness of the organisation of medical education in Ulm, this paper describes concrete measures that were designed at the university or have been partly implemented already. More flexibility and customization are essential characteristics and prerequisites of a family-friendly medical school as part of university education structures. Flexibility and customization can be achieved by designing lesson plans and study regulations so that both childcare is assured and that in emergencies, help can be quickly offered with a minimum of bureaucracy. More flexibility includes, amongst other things, adequate means for the individual to compensate for missed compulsory attendances and examination dates. The necessary shift in thinking and the willingness to cooperate on behalf of the management and teaching staff can be supported through the audit for family-friendliness "berufundfamilie" (job and family) or "familiengerechte hochschule" (family-friendly university), as well as strategic management tools of family-friendly corporate policies. Supporting mechanisms such as effectively networked advice services, course progression monitoring based on data, providing a parents' passport with a cross-semester training contract, creating more interaction between student-parents or other students through a parent community or by study pairings and finally, reliable information on and compliance with the maternity leave rules for pregnant and breastfeeding medical students can help safeguard successful studying with children.

  14. An active learning approach to the physics of medical imaging

    DEFF Research Database (Denmark)

    Wilhjelm, Jens E.; Pihl, Michael Johannes; Lonsdale, Markus Nowak

    2008-01-01

    This paper describes an experimentally oriented medical imaging course where the students record, process and analyse 3D data of an unknown piece of formalin fixed porcine tissue hidden in agar in order to estimate the tissue types present in a selected 2D slice. The recorded planar X-ray, CT, MRI...

  15. A Strategic Approach to Humanitarian Medical Manpower Planning

    Science.gov (United States)

    2008-03-01

    population dynamics, nutrition , reproductive health, health financing, medical resources and usage, immunization, infectious diseases , HIV/Aids, and...maternal health, nutrition , optometry, and preventive health. A second data request by disease cluster to NMCSD for M-2 data focused on capturing...increasing, see Figure 3. In addition, the top ten diseases are identified as ear infection, rheumatism , eye infections, urinary tract infections

  16. Towards a Unified Approach to Information Integration - A review paper on data/information fusion

    Energy Technology Data Exchange (ETDEWEB)

    Whitney, Paul D.; Posse, Christian; Lei, Xingye C.

    2005-10-14

    Information or data fusion of data from different sources are ubiquitous in many applications, from epidemiology, medical, biological, political, and intelligence to military applications. Data fusion involves integration of spectral, imaging, text, and many other sensor data. For example, in epidemiology, information is often obtained based on many studies conducted by different researchers at different regions with different protocols. In the medical field, the diagnosis of a disease is often based on imaging (MRI, X-Ray, CT), clinical examination, and lab results. In the biological field, information is obtained based on studies conducted on many different species. In military field, information is obtained based on data from radar sensors, text messages, chemical biological sensor, acoustic sensor, optical warning and many other sources. Many methodologies are used in the data integration process, from classical, Bayesian, to evidence based expert systems. The implementation of the data integration ranges from pure software design to a mixture of software and hardware. In this review we summarize the methodologies and implementations of data fusion process, and illustrate in more detail the methodologies involved in three examples. We propose a unified multi-stage and multi-path mapping approach to the data fusion process, and point out future prospects and challenges.

  17. A service based approach for medical image distribution in healthcare Intranets.

    Science.gov (United States)

    Kaldoudi, Eleni; Karaiskakis, Dimosthenis

    2006-02-01

    The Digital Imaging and Communications in Medicine (DICOM) protocol is currently the ubiquitous standard for the communication of medical images and related data within the radiology department. However, seamless image distribution within the healthcare enterprise and especially with research and educational information systems is still hard to achieve, as software developers of such third-party applications have to go through the rather cumbersome task of adapting the DICOM communication model and implementing the DICOM protocol. This paper gives a brief outline of current trends in medical image distribution in the healthcare enterprise, and proposes a new technological approach for distributing DICOM images and related data through commonplace Internet technologies, based on the emerging web services software paradigm. In particular, the paper describes the DICOM Image Management (DIM) web service which acts as a façade for conventional DICOM sources allowing DICOM image data and related information, to be transformed into XML documents encapsulated in SOAP messages, enabling integration at the application level through general purpose standardized web technologies. Implementation issues are discussed and a demonstration of engaging the DIM web service is included.

  18. An integrative computational approach for prioritization of genomic variants.

    Directory of Open Access Journals (Sweden)

    Inna Dubchak

    Full Text Available An essential step in the discovery of molecular mechanisms contributing to disease phenotypes and efficient experimental planning is the development of weighted hypotheses that estimate the functional effects of sequence variants discovered by high-throughput genomics. With the increasing specialization of the bioinformatics resources, creating analytical workflows that seamlessly integrate data and bioinformatics tools developed by multiple groups becomes inevitable. Here we present a case study of a use of the distributed analytical environment integrating four complementary specialized resources, namely the Lynx platform, VISTA RViewer, the Developmental Brain Disorders Database (DBDB, and the RaptorX server, for the identification of high-confidence candidate genes contributing to pathogenesis of spina bifida. The analysis resulted in prediction and validation of deleterious mutations in the SLC19A placental transporter in mothers of the affected children that causes narrowing of the outlet channel and therefore leads to the reduced folate permeation rate. The described approach also enabled correct identification of several genes, previously shown to contribute to pathogenesis of spina bifida, and suggestion of additional genes for experimental validations. The study demonstrates that the seamless integration of bioinformatics resources enables fast and efficient prioritization and characterization of genomic factors and molecular networks contributing to the phenotypes of interest.

  19. An Integrative Computational Approach for Prioritization of Genomic Variants

    Science.gov (United States)

    Wang, Sheng; Meyden, Cem; Sulakhe, Dinanath; Poliakov, Alexander; Börnigen, Daniela; Xie, Bingqing; Taylor, Andrew; Ma, Jianzhu; Paciorkowski, Alex R.; Mirzaa, Ghayda M.; Dave, Paul; Agam, Gady; Xu, Jinbo; Al-Gazali, Lihadh; Mason, Christopher E.; Ross, M. Elizabeth; Maltsev, Natalia; Gilliam, T. Conrad

    2014-01-01

    An essential step in the discovery of molecular mechanisms contributing to disease phenotypes and efficient experimental planning is the development of weighted hypotheses that estimate the functional effects of sequence variants discovered by high-throughput genomics. With the increasing specialization of the bioinformatics resources, creating analytical workflows that seamlessly integrate data and bioinformatics tools developed by multiple groups becomes inevitable. Here we present a case study of a use of the distributed analytical environment integrating four complementary specialized resources, namely the Lynx platform, VISTA RViewer, the Developmental Brain Disorders Database (DBDB), and the RaptorX server, for the identification of high-confidence candidate genes contributing to pathogenesis of spina bifida. The analysis resulted in prediction and validation of deleterious mutations in the SLC19A placental transporter in mothers of the affected children that causes narrowing of the outlet channel and therefore leads to the reduced folate permeation rate. The described approach also enabled correct identification of several genes, previously shown to contribute to pathogenesis of spina bifida, and suggestion of additional genes for experimental validations. The study demonstrates that the seamless integration of bioinformatics resources enables fast and efficient prioritization and characterization of genomic factors and molecular networks contributing to the phenotypes of interest. PMID:25506935

  20. Optimizing Groundwater Monitoring Networks Using Integrated Statistical and Geostatistical Approaches

    Directory of Open Access Journals (Sweden)

    Jay Krishna Thakur

    2015-08-01

    Full Text Available The aim of this work is to investigate new approaches using methods based on statistics and geo-statistics for spatio-temporal optimization of groundwater monitoring networks. The formulated and integrated methods were tested with the groundwater quality data set of Bitterfeld/Wolfen, Germany. Spatially, the monitoring network was optimized using geo-statistical methods. Temporal optimization of the monitoring network was carried out using Sen’s method (1968. For geostatistical network optimization, a geostatistical spatio-temporal algorithm was used to identify redundant wells in 2- and 2.5-D Quaternary and Tertiary aquifers. Influences of interpolation block width, dimension, contaminant association, groundwater flow direction and aquifer homogeneity on statistical and geostatistical methods for monitoring network optimization were analysed. The integrated approach shows 37% and 28% redundancies in the monitoring network in Quaternary aquifer and Tertiary aquifer respectively. The geostatistical method also recommends 41 and 22 new monitoring wells in the Quaternary and Tertiary aquifers respectively. In temporal optimization, an overall optimized sampling interval was recommended in terms of lower quartile (238 days, median quartile (317 days and upper quartile (401 days in the research area of Bitterfeld/Wolfen. Demonstrated methods for improving groundwater monitoring network can be used in real monitoring network optimization with due consideration given to influencing factors.

  1. The meaning of integrated care: a systems approach

    Directory of Open Access Journals (Sweden)

    Lars Edgren

    2008-10-01

    Full Text Available Introduction: Organizations can be regarded as systems. The traditional model of systems views them as machines. This seems to be insufficient when it comes to understanding and organizing complex tasks. To better understand integrated care we should approach organizations as constantly changing living organisms, where many agents are interconnected in so-called Complex Adaptive Systems (CAS. Theory and discussion: The term “complex” emphasizes that the necessary competence to perform a task is not owned by any one part, but comes as a result of co-operation within the system. “Adaptive” means that system change occurs through successive adaptations. A CAS consists of several subsystems called agents, which act in dependence of one another. Examples would be the ant-hill, the human immune defence, the financial market and the surgical operating theatre team. Studying a CAS, the focus is on the interaction and communication between agents. Although these thoughts are not new, the CAS-approach has not yet been widely applied to the management of integrated care. This helps the management to understand why the traditional top down way of managing, following the machine model thinking, may meet with problems in interdependent organizations with complex tasks. Conclusion: When we perceive health and social services as CASs we should gain more insight into the processes that go on within and between organizations and how top management, for example within a hospital, in fact executes its steering function.

  2. Thanatophobia in medical students: approach to death and dying patients attitude scale (ADDPAS) for undergraduate years in medicine.

    Science.gov (United States)

    Kavas, Mustafa Volkan; Oztuna, Derya

    2011-12-01

    In recent decades growing efforts in Western countries in integrating end-of-life care issues into undergraduate medical education have been conspicuous. However, studies in this field are limited in Turkey. We aimed, therefore, as a first step, to develop an attitude scale in order to obtain objective data regarding medical students' approaches to death and dying patients. After applying the scale on medical students and performing exploratory factor analysis, it was found out to be composed of a two-dimensional structure. Then the internal construct validity of these dimensions was subjected to Rasch analysis and the reliability of them was tested by internal consistency and person separation index. As a result of overall analyses, we suggest a new scale which is capable of making valid and reliable measurements.

  3. An integrated systems engineering approach to aircraft design

    Science.gov (United States)

    Price, M.; Raghunathan, S.; Curran, R.

    2006-06-01

    The challenge in Aerospace Engineering, in the next two decades as set by Vision 2020, is to meet the targets of reduction of nitric oxide emission by 80%, carbon monoxide and carbon dioxide both by 50%, reduce noise by 50% and of course with reduced cost and improved safety. All this must be achieved with expected increase in capacity and demand. Such a challenge has to be in a background where the understanding of physics of flight has changed very little over the years and where industrial growth is driven primarily by cost rather than new technology. The way forward to meet the challenges is to introduce innovative technologies and develop an integrated, effective and efficient process for the life cycle design of aircraft, known as systems engineering (SE). SE is a holistic approach to a product that comprises several components. Customer specifications, conceptual design, risk analysis, functional analysis and architecture, physical architecture, design analysis and synthesis, and trade studies and optimisation, manufacturing, testing validation and verification, delivery, life cycle cost and management. Further, it involves interaction between traditional disciplines such as Aerodynamics, Structures and Flight Mechanics with people- and process-oriented disciplines such as Management, Manufacturing, and Technology Transfer. SE has become the state-of-the-art methodology for organising and managing aerospace production. However, like many well founded methodologies, it is more difficult to embody the core principles into formalised models and tools. The key contribution of the paper will be to review this formalisation and to present the very latest knowledge and technology that facilitates SE theory. Typically, research into SE provides a deeper understanding of the core principles and interactions, and helps one to appreciate the required technical architecture for fully exploiting it as a process, rather than a series of events. There are major issues as

  4. Integrated System Health Management: Foundational Concepts, Approach, and Implementation.

    Science.gov (United States)

    Figueroa, Fernando; Schmalzel, John; Walker, Mark; Venkatesh, Meera; Kapadia, Ravi; Morris, Jon; Turowski, Mark; Smith, Harvey

    2009-01-01

    Implementation of integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive to an accurate and reliable assessment of its health. We present concepts, procedures, and a specific approach as a foundation for implementing a credible ISHM capability. The capability stresses integration of DIaK from all elements of a system. The intent is also to make possible implementation of on-board ISHM capability, in contrast to a remote capability. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems (rocket engine test facilities). The paper will address the following topics: 1. ISHM Model of a system 2. Detection of anomaly indicators. 3. Determination and confirmation of anomalies. 4. Diagnostic of causes and determination of effects. 5. Consistency checking cycle. 6. Management of health information 7. User Interfaces 8. Example implementation ISHM has been defined from many perspectives. We define it as a capability that might be achieved by various approaches. We describe a specific approach that has been matured throughout many years of development, and pilot implementations. ISHM is a capability that is achieved by integrating data, information, and knowledge (DIaK) that might be distributed throughout the system elements (which inherently implies capability to manage DIaK associated with distributed sub-systems). DIaK must be available to any element of a system at the right time and in accordance with a meaningful context. ISHM Functional Capability Level (FCL) is measured by how well a system performs the following

  5. [The combination of "Careworks" insurance plan integrated with medical and long-term care insurance].

    Science.gov (United States)

    Sumii, Hiroshi

    2006-11-01

    The social security system in Japan was greatly revolutionized when the long-term care insurance plan began in April 2000. Thus, Japan began the 21st century with two great social insurance plans, that is, medical care insurance and long-term care insurance. Each delivery system is divided: the medical care insurance plan is for the acute stage, and the long-term care is for the chronic stage. Both systems can be intended to cooperate to provide continuous care throughout life. The public health and welfare system has been trying hard to efficiently integrate the medical and long-term care insurance plans. However, it is necessary to establish a new insurance plan for ensuring the integrated adequacy of both insurance systems. One's life is destined to shift from medical care to long-term care at some point. As one ages or becomes disabled, it becomes difficult to lead an independent life with self-decision, and social support become necessary from third parties, instead of from the family or from one's own means. The society imposes the responsibility of payment of the medical and long-term care plan premiums on the individual throughout life. However, the structure of these insurance foundations should be combined under an integrated system, "Careworks", in order to also combine the concepts of length of life from the medicine and the respect of living from the long-term case to improve the social security of the life.

  6. Implementation and evolution of the horizontal integration at shiraz medical school

    Directory of Open Access Journals (Sweden)

    MITRA AMINI

    2013-01-01

    Full Text Available Introduction: General medical education starts with basic sciences which usually continue about 2.5 to 3 years. In this period, the students study basic medical sciences and then start the clinical stage in which they deal with diagnoses, care, and cure of disease. The purpose of this study was to assess the integration of basic sciences period with the clinical period at Shiraz University of Medical Sciences. Methods: The present study is a descriptive one. The sample of the study consisted of all students entered Shiraz University of Medical Sciences in January, 2009, and November, 2009, professors of basic sciences courses, and some clinical professors. To evaluate the integration program, we devised various instruments. The collected data were analyzed, using SPSS software. Result: The findings showed that in spite of the students’ objections new educational methods in the first year of implementation, they felt more satisfied as the drawbacks were removed over time. Conclusion: The assessment of educational curricula is an important step to identify educational problems and promote the students’ learning. This issue can help the curriculum planners to design the educational programs so that students, particularly medical students, will be able to acquire the required knowledge and skill and integrate them for the promotion and maintenance of society’s health.

  7. Treatment of cerebral palsy children by integrative medical sequential method:a clinical efficacy observation

    Institute of Scientific and Technical Information of China (English)

    王丽芳

    2014-01-01

    Objective To observe the efficacy of integrative medical sequential method in treating cerebral palsy(CP)children’s intelligence development,muscular tension,serum interleukin 6(IL-6),and tumor necrosisfactorα(TNF-α).Methods Totally 111 CP children were randomly assigned to the control group(50 cases)and the treatment group(61 cases).All patients received

  8. Self-Referent Constructs and Medical Sociology: In Search of an Integrative Framework

    Science.gov (United States)

    Kaplan, Howard B.

    2007-01-01

    A theoretical framework centering on four classes of self-referent constructs is offered as a device for integrating the diverse areas constituting medical sociology. Guidance by this framework sensitizes the researcher to the occurrence of parallel processes in adjacent disciplines, facilitates recognition of the etiological significance of…

  9. Challenges and opportunities for integrating lake ecosystem modelling approaches

    Science.gov (United States)

    Mooij, Wolf M.; Trolle, Dennis; Jeppesen, Erik; Arhonditsis, George; Belolipetsky, Pavel V.; Chitamwebwa, Deonatus B.R.; Degermendzhy, Andrey G.; DeAngelis, Donald L.; Domis, Lisette N. De Senerpont; Downing, Andrea S.; Elliott, J. Alex; Ruberto, Carlos Ruberto; Gaedke, Ursula; Genova, Svetlana N.; Gulati, Ramesh D.; Hakanson, Lars; Hamilton, David P.; Hipsey, Matthew R.; Hoen, Jochem 't; Hulsmann, Stephan; Los, F. Hans; Makler-Pick, Vardit; Petzoldt, Thomas; Prokopkin, Igor G.; Rinke, Karsten; Schep, Sebastiaan A.; Tominaga, Koji; Van Dam, Anne A.; Van Nes, Egbert H.; Wells, Scott A.; Janse, Jan H.

    2010-01-01

    A large number and wide variety of lake ecosystem models have been developed and published during the past four decades. We identify two challenges for making further progress in this field. One such challenge is to avoid developing more models largely following the concept of others ('reinventing the wheel'). The other challenge is to avoid focusing on only one type of model, while ignoring new and diverse approaches that have become available ('having tunnel vision'). In this paper, we aim at improving the awareness of existing models and knowledge of concurrent approaches in lake ecosystem modelling, without covering all possible model tools and avenues. First, we present a broad variety of modelling approaches. To illustrate these approaches, we give brief descriptions of rather arbitrarily selected sets of specific models. We deal with static models (steady state and regression models), complex dynamic models (CAEDYM, CE-QUAL-W2, Delft 3D-ECO, LakeMab, LakeWeb, MyLake, PCLake, PROTECH, SALMO), structurally dynamic models and minimal dynamic models. We also discuss a group of approaches that could all be classified as individual based: super-individual models (Piscator, Charisma), physiologically structured models, stage-structured models and trait-based models. We briefly mention genetic algorithms, neural networks, Kalman filters and fuzzy logic. Thereafter, we zoom in, as an in-depth example, on the multi-decadal development and application of the lake ecosystem model PCLake and related models (PCLake Metamodel, Lake Shira Model, IPH-TRIM3D-PCLake). In the discussion, we argue that while the historical development of each approach and model is understandable given its 'leading principle', there are many opportunities for combining approaches. We take the point of view that a single 'right' approach does not exist and should not be strived for. Instead, multiple modelling approaches, applied concurrently to a given problem, can help develop an integrative

  10. Preventing medication errors in transitions of care: A patient case approach.

    Science.gov (United States)

    Johnson, Ashley; Guirguis, Erenie; Grace, Yasmin

    2015-01-01

    To discuss common causes of medication errors occurring upon transitions of care and review key interventions that should be implemented to ensure effective communication and accurate completion of medication reconciliation. MEDLINE (1946 to November 2014) using MeSH terms medication errors, medication reconciliation, and nursing homes in addition to conventional text words, including transitions of care and medication safety; Agency for Healthcare Research and Quality Patient Safety Network using search terms transitions of care, medication errors, and medication reconciliation; and relevant websites of national organizations pertaining to transitions of care and medication reconciliation. Limited to English-language journals with no limitation set on the year of publication for clinical trials, meta-analyses, and reviews. At the authors' discretion, preference was given to references focusing on pharmacists' role in transitions of care and medication reconciliation. Most medication errors stem from a lack of effective communication between health care providers during transitions of care. Part of successful communication and correct patient hand-off is completing accurate medication reconciliation. A patient case highlights a life-threatening medication error that occurred during a transition of care due to ineffective communication between a pharmacist and nurse while transferring medication information. To provide patients with accurate medication information, pharmacists should perform medication reconciliation upon transitions of care using The Joint Commission's five-step process. Pharmacists can conduct numerous interventions to prevent medication errors during transitions of care and ensure patient safety. Pharmacists are integral to evaluating the appropriateness of medication use, ensuring information is updated in the health record, and verbally communicating accurate information to other health professionals.

  11. Implementing an integrated care management program in community pharmacies: A focus on medication management services.

    Science.gov (United States)

    Smith, Megan G; Ferreri, Stefanie P; Brown, Patrick; Wines, Kristen; Shea, Christopher M; Pfeiffenberger, Trista M

    To describe the initiation of a community pharmacy medication management service within a statewide integrated care management program. One hundred twenty-three community and community health center pharmacies in 58 counties of North Carolina. Independent and community health center pharmacies offering medication management as part of an integrated care management program to Medicaid, Medicare, dually eligible Medicare-Medicaid, and NC Health Choice beneficiaries in North Carolina. Community pharmacies joined an enhanced service network created by Community Care of North Carolina to provide medication management services as part of an integrated care management program. During the first 3 months of the program, 41% of pharmacies consistently documented the medication management services. Interviews were conducted with pharmacists from the inconsistent pharmacies to drive program improvements. Pharmacists at 73 community and community health center pharmacies were interviewed. The majority of pharmacists reported that challenges in "initiating services" and "documenting" were due to increased intensity of service and documentation compared with Medicare Part D medication therapy management requirements. Program changes to improve participation included revision of documentation requirements, authorization of technicians to transcribe pharmacists' interventions, additional documentation templates, workflow consultations, and feedback on documentation quality. Community pharmacies are capable of providing medication management integrated with care management. Some pharmacies have more difficulty initiating new services in the current workflow landscape. To facilitate implementation, it is important to minimize administrative burden and provide mechanisms for direct feedback. Pharmacy owners, managers, and leaders in pharmacy policy can use these findings to aid implementation of new services in community pharmacies. Copyright © 2016 American Pharmacists Association

  12. [Methodological approach to the history of medical hydrology].

    Science.gov (United States)

    Rodríguez-Sánchez, J A

    1993-01-01

    An historical study of medical hydrology allows us to outline a clear social history in Spain. The author identifies three groups of people living and working in and around thermal baths; he suggests studying relations between doctors and patients, therms economics, the social life in baths and the organization of people living around them. A correct use of handwritten and printed sources describing various aspects of thermal life can help us to understand an always interesting phenomenon.

  13. Time for a unified approach to medical ethics

    Directory of Open Access Journals (Sweden)

    McNamee Turi

    2009-09-01

    Full Text Available Abstract A code of ethics is used by individuals to justify their actions within an environment. Medical professionals require a keen understanding of specific ethical codes due to the potential consequences of their actions. Over the past thirty years there has been an increase in the scope and depth of ethics instruction in the medical profession; however the teaching of these codes is still highly variable. This inconsistency in implementation is problematic both for the medical practitioner and for the patient; without standardized training, neither party can be assured of the practitioner's overall depth of knowledge. Within the field of ethics certain principles have reached a consensus of importance. Incorporation of these concepts in meaningful ways via a consistent curriculum would provide students with an appropriate skill set for navigating their ethical environment. Moreover, this curriculum should also be extended to residents and professionals who may have missed formal ethical training. This would provide a consistent framework of knowledge for practitioners, creating a basis for clear judgment of complex issues.

  14. Supporting Medical Research on Chronic Diseases using Integrated Health Monitoring Platform

    OpenAIRE

    Krukowski, Artur; Vogiatzaki, Emmanouela; Charalambides, Marios; Chouchoulis, Michalis

    2014-01-01

    This paper describes combined experiences in developing e-Health platforms and services with respect of supporting medical research into the causes and relationships among physiological parameters and health problems concerning different chronic diseases, from cardiovascular to stroke, epilepsy, and others. The Personal Health Records (PHR) is presented as new technological approaches aimed at standardizing electronic management of medical information between the patient and its physicians, a...

  15. Neurocognition, insight and medication nonadherence in schizophrenia: a structural equation modeling approach.

    Directory of Open Access Journals (Sweden)

    Laurent Boyer

    Full Text Available OBJECTIVE: The aim of this study was to examine the complex relationships among neurocognition, insight and nonadherence in patients with schizophrenia. METHODS: DESIGN: Cross-sectional study. INCLUSION CRITERIA: Diagnosis of schizophrenia according to the DSM-IV-TR criteria. DATA COLLECTION: Neurocognition was assessed using a global approach that addressed memory, attention, and executive functions; insight was analyzed using the multidimensional 'Scale to assess Unawareness of Mental Disorder;' and nonadherence was measured using the multidimensional 'Medication Adherence Rating Scale.' ANALYSIS: Structural equation modeling (SEM was applied to examine the non-straightforward relationships among the following latent variables: neurocognition, 'awareness of positive symptoms' and 'negative symptoms', 'awareness of mental disorder' and nonadherence. RESULTS: One hundred and sixty-nine patients were enrolled. The final testing model showed good fit, with normed χ(2 = 1.67, RMSEA = 0.063, CFI = 0.94, and SRMR = 0.092. The SEM revealed significant associations between (1 neurocognition and 'awareness of symptoms,' (2 'awareness of symptoms' and 'awareness of mental disorder' and (3 'awareness of mental disorder' and nonadherence, mainly in the 'attitude toward taking medication' dimension. In contrast, there were no significant links between neurocognition and nonadherence, neurocognition and 'awareness of mental disorder,' and 'awareness of symptoms' and nonadherence. CONCLUSIONS: Our findings support the hypothesis that neurocognition influences 'awareness of symptoms,' which must be integrated into a higher level of insight (i.e., the 'awareness of mental disorder' to have an impact on nonadherence. These findings have important implications for the development of effective strategies to enhance medication adherence.

  16. Medical image integrity control and forensics based on watermarking--approximating local modifications and identifying global image alterations.

    Science.gov (United States)

    Huang, H; Coatrieux, G; Shu, H Z; Luo, L M; Roux, Ch

    2011-01-01

    In this paper we present a medical image integrity verification system that not only allows detecting and approximating malevolent local image alterations (e.g. removal or addition of findings) but is also capable to identify the nature of global image processing applied to the image (e.g. lossy compression, filtering …). For that purpose, we propose an image signature derived from the geometric moments of pixel blocks. Such a signature is computed over regions of interest of the image and then watermarked in regions of non interest. Image integrity analysis is conducted by comparing embedded and recomputed signatures. If any, local modifications are approximated through the determination of the parameters of the nearest generalized 2D Gaussian. Image moments are taken as image features and serve as inputs to one classifier we learned to discriminate the type of global image processing. Experimental results with both local and global modifications illustrate the overall performances of our approach.

  17. Integrated Medical-Dental Delivery Systems: Models in a Changing Environment and Their Implications for Dental Education.

    Science.gov (United States)

    Jones, Judith A; Snyder, John J; Gesko, David S; Helgeson, Michael J

    2017-09-01

    Models and systems of the dental care delivery system are changing. Solo practice is no longer the only alternative for graduating dentists. Over half of recent graduates are employees, and more than ever before, dentists are practicing in groups. This trend is expected to increase over the next 25 years. This article examines various models of dental care delivery, explains why it is important to practice in integrated medical-dental teams, and defines person-centered care, contrasting it with patient-centered care. Systems of care in which teams are currently practicing integrated oral health care delivery are described, along with speculation on the future of person-centered care and the team approach. Critical steps in the education of dental and other health care professionals and the development of clinical models of care in moving forward are considered. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."

  18. Finding Practical Approaches to Integrated Water Resources Management

    Directory of Open Access Journals (Sweden)

    John Butterworth

    2010-02-01

    Full Text Available Integrated Water Resources Management (IWRM has often been interpreted and implemented in a way that is only really suited to countries with the most developed water infrastructures and management capacities. While sympathetic to many of the criticisms levelled at the IWRM concept and recognising the often disappointing levels of adoption, this paper and the series of papers it introduces identify some alternative ways forward in a developmental context that place more emphasis on the practical in-finding solutions to water scarcity. A range of lighter, more pragmatic and context-adapted approaches, strategies and entry points are illustrated with examples from projects and initiatives in mainly 'developing' countries. The authors argue that a more service-orientated (WASH, irrigation and ecosystem services, locally rooted and balanced approach to IWRM that better matches contexts and capacities should build on such strategies, in addition to the necessary but long-term policy reforms and river basin institution-building at higher levels. Examples in this set of papers not only show that the 'lighter', more opportunistic and incremental approach has potential as well as limitations but also await wider piloting and adoption.

  19. Adaptive XML to relational mapping: an integrated approach

    Institute of Scientific and Technical Information of China (English)

    Tian-lei HU; Gang CHEN

    2008-01-01

    Storing and querying XML (eXtensible Markup Language) data in relational form can exploit various services offered by modem relational database management systems (RDBMSs). Due to structural complexity of XML, there are many equivalent relational mapping schemes for the same XML data and queries. In this paper, we propose the adaptive XML to relational mapping (AX2RM) system, which considers finding optimal XML to relational (X2R) mapping as four separate but correlated procedures: logical database design, data scale estimation, workload transformation, and physical database design. We view the whole process as an autonomic computing problem and formalize the adaptive X2R mapping problem. Search spaces for each procedure are investigated individually, and five approaches for finding the optimal mapping are studied. We propose an integrated approach with greedy pruning (IT-GP), which views the mapping procedures as a whole and exploits heuristic rules in each procedure to prune impossible mappings as early as possible. Evaluation of these approaches shows the validity and high efficiency of IT-GP.

  20. Contingent approach to Internet-based supply network integration

    Science.gov (United States)

    Ho, Jessica; Boughton, Nick; Kehoe, Dennis; Michaelides, Zenon

    2001-10-01

    The Internet is playing an increasingly important role in enhancing the operations of supply networks as many organizations begin to recognize the benefits of Internet- enabled supply arrangements. However, the developments and applications to-date do not extend significantly beyond the dyadic model, whereas the real advantages are to be made with the external and network models to support a coordinated and collaborative based approach. The DOMAIN research group at the University of Liverpool is currently defining new Internet- enabled approaches to enable greater collaboration across supply chains. Different e-business models and tools are focusing on different applications. Using inappropriate e- business models, tools or techniques will bring negative results instead of benefits to all the tiers in the supply network. Thus there are a number of issues to be considered before addressing Internet based supply network integration, in particular an understanding of supply chain management, the emergent business models and evaluating the effects of deploying e-business to the supply network or a particular tier. It is important to utilize a contingent approach to selecting the right e-business model to meet the specific supply chain requirements. This paper addresses the issues and provides a case study on the indirect materials supply networks.

  1. Segmentation of Pre-processed Medical Images: An Approach Based on Range Filter

    Directory of Open Access Journals (Sweden)

    Amir Rajaei

    2012-09-01

    Full Text Available Medical image segmentation is a frequent processing step. Medical images are suffering from unrelated article and strong speckle noise. In this paper, we propose an approach to remove special markings such as arrow symbols and printed text along with medical image segmentation using range filter. The special markings are extracted using Sobel edge detection technique and then the intensity values of the detected markings are substituted by the intensity values of their corresponding neighborhood pixels. Next, three different image enhancement techniques are utilized to remove strong speckle noise as well enhance the weak boundaries of medical images. Finally range filter is applied to segment the texture content of different modalities of medical image. Experiment is conducted on ImageCLEF2010 database. Results show the efficacy of our proposed approach which lead to have precise content based medical image classification and retrieval systems.

  2. 3D thermal medical image visualization tool: Integration between MRI and thermographic images.

    Science.gov (United States)

    Abreu de Souza, Mauren; Chagas Paz, André Augusto; Sanches, Ionildo Jóse; Nohama, Percy; Gamba, Humberto Remigio

    2014-01-01

    Three-dimensional medical image reconstruction using different images modalities require registration techniques that are, in general, based on the stacking of 2D MRI/CT images slices. In this way, the integration of two different imaging modalities: anatomical (MRI/CT) and physiological information (infrared image), to generate a 3D thermal model, is a new methodology still under development. This paper presents a 3D THERMO interface that provides flexibility for the 3D visualization: it incorporates the DICOM parameters; different color scale palettes at the final 3D model; 3D visualization at different planes of sections; and a filtering option that provides better image visualization. To summarize, the 3D thermographc medical image visualization provides a realistic and precise medical tool. The merging of two different imaging modalities allows better quality and more fidelity, especially for medical applications in which the temperature changes are clinically significant.

  3. Novel lattice Boltzmann method based on integrated edge and region information for medical image segmentation.

    Science.gov (United States)

    Wen, Junling; Yan, Zhuangzhi; Jiang, Jiehui

    2014-01-01

    The lattice Boltzmann (LB) method is a mesoscopic method based on kinetic theory and statistical mechanics. The main advantage of the LB method is parallel computation, which increases the speed of calculation. In the past decade, LB methods have gradually been introduced for image processing, e.g., image segmentation. However, a major shortcoming of existing LB methods is that they can only be applied to the processing of medical images with intensity homogeneity. In practice, however, many medical images possess intensity inhomogeneity. In this study, we developed a novel LB method to integrate edge and region information for medical image segmentation. In contrast to other segmentation methods, we added edge information as a relaxing factor and used region information as a source term. The proposed method facilitates the segmentation of medical images with intensity inhomogeneity and it still allows parallel computation. Preliminary tests of the proposed method are presented in this paper.

  4. An Approach to Integer Wavelet Transform for Medical Image Compression in PACS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    We study an approach to integer wavelet transform for lossless compression of medical image in medical picture archiving and communication system (PACS). By lifting scheme a reversible integer wavelet transform is generated, which has the similar features with the corresponding biorthogonal wavelet transform. Experimental results of the method based on integer wavelet transform are given to show better performance and great applicable potentiality in medical image compression.

  5. Linking Science and Language Arts: A Review of the Literature Which Compares Integrated versus Non-Integrated Approaches

    Science.gov (United States)

    Bradbury, Leslie U.

    2014-01-01

    The purpose of this paper is to review the literature published during the last 20 years that investigates the impact of approaches that describe themselves as integrating science and language arts on student learning and/or attitude at the elementary level. The majority of papers report that integrated approaches led to greater student…

  6. Contextualizing the relevance of basic sciences: small-group simulation with debrief for first- and second-year medical students in an integrated curriculum.

    Science.gov (United States)

    Ginzburg, Samara B; Brenner, Judith; Cassara, Michael; Kwiatkowski, Thomas; Willey, Joanne M

    2017-01-01

    There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients. Small groups of first- and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience. The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students) and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students). In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences. Small-group simulation followed by a debrief that integrates basic and clinical sciences is an effective means of demonstrating the relationship between scientific fundamentals and patient care for early learners. As more medical schools embrace integrated curricula and seek opportunities for integration, our model is a novel approach that can be utilized.

  7. Contextualizing the relevance of basic sciences: small-group simulation with debrief for first- and second-year medical students in an integrated curriculum

    Science.gov (United States)

    Ginzburg, Samara B; Brenner, Judith; Cassara, Michael; Kwiatkowski, Thomas; Willey, Joanne M

    2017-01-01

    Aim There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients. Methods Small groups of first- and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience. Results The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students) and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students). In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences. Conclusion Small-group simulation followed by a debrief that integrates basic and clinical sciences is an effective means of demonstrating the relationship between scientific fundamentals and patient care for early learners. As more medical schools embrace integrated curricula and seek opportunities for integration, our model is a novel approach that can be utilized

  8. Medical assistance as a process. Application of a systemic approach to the study of the medical assistance.

    Directory of Open Access Journals (Sweden)

    Luis Alberto Corona Martínez

    2005-08-01

    Full Text Available This article presents the concepts that give theoretical support to the character of the medical assistance as a process. From this point of view the analysis of the process is carried out following a systemic approach, allowing the identification of the components of the process: object- subject- objective-problem- method- content- material aids teaching form and result s, all of which form the eternal structure of the process. Teaching, investigative and assistencial implications of this process are present as well as its contribution for the medical practice of the new doctors.

  9. A Human-Centered Approach to Medical Informatics for Medical Students, Residents, and Practicing Clinicians.

    Science.gov (United States)

    Stahlhut, Richard W.; Gosbee, John W.; Gardner-Bonneau, Daryle J.

    1997-01-01

    Describes development of a curriculum in medical information science that focuses on practical problems in clinical medicine rather than details of information technology. Design was guided by identification of six key clinical challenges that must be addressed by practitioners in the near future and by examination of past failures of informatics…

  10. Science based integrated approach to advanced nuclear fuel development - vision, approach, and overview

    Energy Technology Data Exchange (ETDEWEB)

    Unal, Cetin [Los Alamos National Laboratory; Pasamehmetoglu, Kemal [IDAHO NATIONAL LAB; Carmack, Jon [IDAHO NATIONAL LAB

    2010-01-01

    Advancing the performance of Light Water Reactors, Advanced Nuclear Fuel Cycles, and Advanced Rcactors, such as the Next Generation Nuclear Power Plants, requires enhancing our fundamental understanding of fuel and materials behavior under irradiation. The capability to accurately model the nuclear fuel systems is critical. In order to understand specific aspects of the nuclear fuel, fully coupled fuel simulation codes are required to achieve licensing of specific nuclear fuel designs for operation. The backbone of these codes, models, and simulations is a fundamental understanding and predictive capability for simulating the phase and microstructural behavior of the nuclear fuel system materials and matrices. The purpose of this paper is to identify the modeling and simulation approach in order to deliver predictive tools for advanced fuels development. The coordination between experimental nuclear fuel design, development technical experts, and computational fuel modeling and simulation technical experts is a critical aspect of the approach and naturally leads to an integrated, goal-oriented science-based R & D approach and strengthens both the experimental and computational efforts. The Advanced Fuels Campaign (AFC) and Nuclear Energy Advanced Modeling and Simulation (NEAMS) Fuels Integrated Performance and Safety Code (IPSC) are working together to determine experimental data and modeling needs. The primary objective of the NEAMS fuels IPSC project is to deliver a coupled, three-dimensional, predictive computational platform for modeling the fabrication and both normal and abnormal operation of nuclear fuel pins and assemblies, applicable to both existing and future reactor fuel designs. The science based program is pursuing the development of an integrated multi-scale and multi-physics modeling and simulation platform for nuclear fuels. This overview paper discusses the vision, goals and approaches how to develop and implement the new approach.

  11. Science based integrated approach to advanced nuclear fuel development - vision, approach, and overview

    Energy Technology Data Exchange (ETDEWEB)

    Unal, Cetin [Los Alamos National Laboratory; Pasamehmetoglu, Kemal [IDAHO NATIONAL LAB; Carmack, Jon [IDAHO NATIONAL LAB

    2010-01-01

    Advancing the performance of Light Water Reactors, Advanced Nuclear Fuel Cycles, and Advanced Rcactors, such as the Next Generation Nuclear Power Plants, requires enhancing our fundamental understanding of fuel and materials behavior under irradiation. The capability to accurately model the nuclear fuel systems is critical. In order to understand specific aspects of the nuclear fuel, fully coupled fuel simulation codes are required to achieve licensing of specific nuclear fuel designs for operation. The backbone of these codes, models, and simulations is a fundamental understanding and predictive capability for simulating the phase and microstructural behavior of the nuclear fuel system materials and matrices. The purpose of this paper is to identify the modeling and simulation approach in order to deliver predictive tools for advanced fuels development. The coordination between experimental nuclear fuel design, development technical experts, and computational fuel modeling and simulation technical experts is a critical aspect of the approach and naturally leads to an integrated, goal-oriented science-based R & D approach and strengthens both the experimental and computational efforts. The Advanced Fuels Campaign (AFC) and Nuclear Energy Advanced Modeling and Simulation (NEAMS) Fuels Integrated Performance and Safety Code (IPSC) are working together to determine experimental data and modeling needs. The primary objective of the NEAMS fuels IPSC project is to deliver a coupled, three-dimensional, predictive computational platform for modeling the fabrication and both normal and abnormal operation of nuclear fuel pins and assemblies, applicable to both existing and future reactor fuel designs. The science based program is pursuing the development of an integrated multi-scale and multi-physics modeling and simulation platform for nuclear fuels. This overview paper discusses the vision, goals and approaches how to develop and implement the new approach.

  12. Biofilm eradication and prevention: a pharmaceutical approach to medical device infections

    National Research Council Canada - National Science Library

    Shunmugaperumal, Tamilvanan

    2010-01-01

    "Biofilm Eradication and Preventions presents the basics of biofilm formation on medical devices, diseases related to this formation, and approaches pharmaceutical researchers need to take to limit this problem...

  13. Systems approaches to integrated solid waste management in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Marshall, Rachael E., E-mail: rmarsh01@uoguelph.ca [School of Engineering, University of Guelph, Albert A. Thornbrough Building, Guelph, ON, Canada N1G 2W1 (Canada); Farahbakhsh, Khosrow, E-mail: khosrowf@uoguelph.ca [School of Engineering, University of Guelph, Albert A. Thornbrough Building, Guelph, ON, Canada N1G 2W1 (Canada)

    2013-04-15

    Highlights: ► Five drivers led developed countries to current solid waste management paradigm. ► Many unique factors challenge developing country solid waste management. ► Limited transferability of developed country approaches to developing countries. ► High uncertainties and decision stakes call for post-normal approaches. ► Systems thinking needed for multi-scale, self-organizing eco-social waste systems. - Abstract: Solid waste management (SWM) has become an issue of increasing global concern as urban populations continue to rise and consumption patterns change. The health and environmental implications associated with SWM are mounting in urgency, particularly in the context of developing countries. While systems analyses largely targeting well-defined, engineered systems have been used to help SWM agencies in industrialized countries since the 1960s, collection and removal dominate the SWM sector in developing countries. This review contrasts the history and current paradigms of SWM practices and policies in industrialized countries with the current challenges and complexities faced in developing country SWM. In industrialized countries, public health, environment, resource scarcity, climate change, and public awareness and participation have acted as SWM drivers towards the current paradigm of integrated SWM. However, urbanization, inequality, and economic growth; cultural and socio-economic aspects; policy, governance, and institutional issues; and international influences have complicated SWM in developing countries. This has limited the applicability of approaches that were successful along the SWM development trajectories of industrialized countries. This review demonstrates the importance of founding new SWM approaches for developing country contexts in post-normal science and complex, adaptive systems thinking.

  14. Modeling fabrication of nuclear components: An integrative approach

    Energy Technology Data Exchange (ETDEWEB)

    Hench, K.W.

    1996-08-01

    Reduction of the nuclear weapons stockpile and the general downsizing of the nuclear weapons complex has presented challenges for Los Alamos. One is to design an optimized fabrication facility to manufacture nuclear weapon primary components in an environment of intense regulation and shrinking budgets. This dissertation presents an integrative two-stage approach to modeling the casting operation for fabrication of nuclear weapon primary components. The first stage optimizes personnel radiation exposure for the casting operation layout by modeling the operation as a facility layout problem formulated as a quadratic assignment problem. The solution procedure uses an evolutionary heuristic technique. The best solutions to the layout problem are used as input to the second stage - a simulation model that assesses the impact of competing layouts on operational performance. The focus of the simulation model is to determine the layout that minimizes personnel radiation exposures and nuclear material movement, and maximizes the utilization of capacity for finished units.

  15. Infectious diseases in oyster aquaculture require a new integrated approach

    Science.gov (United States)

    Lupo, Coralie; Whittington, Richard J.

    2016-01-01

    Emerging diseases pose a recurrent threat to bivalve aquaculture. Recently, massive mortality events in the Pacific oyster Crassostrea gigas associated with the detection of a microvariant of the ostreid herpesvirus 1 (OsHV-1µVar) have been reported in Europe, Australia and New Zealand. Although the spread of disease is often viewed as a governance failure, we suggest that the development of protective measures for bivalve farming is presently held back by the lack of key scientific knowledge. In this paper, we explore the case for an integrated approach to study the management of bivalve disease, using OsHV-1 as a case study. Reconsidering the key issues by incorporating multidisciplinary science could provide a holistic understanding of OsHV-1 and increase the benefit of research to policymakers. PMID:26880845

  16. CLARM: An integrative approach for functional modules discovery

    KAUST Repository

    Salem, Saeed M.

    2011-01-01

    Functional module discovery aims to find well-connected subnetworks which can serve as candidate protein complexes. Advances in High-throughput proteomic technologies have enabled the collection of large amount of interaction data as well as gene expression data. We propose, CLARM, a clustering algorithm that integrates gene expression profiles and protein protein interaction network for biological modules discovery. The main premise is that by enriching the interaction network by adding interactions between genes which are highly co-expressed over a wide range of biological and environmental conditions, we can improve the quality of the discovered modules. Protein protein interactions, known protein complexes, and gene expression profiles for diverse environmental conditions from the yeast Saccharomyces cerevisiae were used for evaluate the biological significance of the reported modules. Our experiments show that the CLARM approach is competitive to wellestablished module discovery methods. Copyright © 2011 ACM.

  17. First- and Third-person Approaches: the Problem of Integration

    Directory of Open Access Journals (Sweden)

    Olga Markič

    2012-10-01

    Full Text Available The author discusses the problem of integration of first- and third-person approaches in studying the human mind. She critically evaluates and compares various methodologies for studying and explaining conscious experience. Common strategies that apply reductive explanation seem to be unsatisfied for explaining experience and its subjective character. There were attempts to explain experience from the first-person point of view (introspectionism, philosophical phenomenology but the results were not intersubjectively verifiable. Dennett proposed heterophenomenology as a scientifically viable alternative which supposed to bridge the gap between first- and third-person perspectives. The author critically evaluates his proposal and compares it to contemporary attempts to provide first-person methods.

  18. Strategic Technology Investment Analysis: An Integrated System Approach

    Science.gov (United States)

    Adumitroaie, V.; Weisbin, C. R.

    2010-01-01

    Complex technology investment decisions within NASA are increasingly difficult to make such that the end results are satisfying the technical objectives and all the organizational constraints. Due to a restricted science budget environment and numerous required technology developments, the investment decisions need to take into account not only the functional impact on the program goals, but also development uncertainties and cost variations along with maintaining a healthy workforce. This paper describes an approach for optimizing and qualifying technology investment portfolios from the perspective of an integrated system model. The methodology encompasses multi-attribute decision theory elements and sensitivity analysis. The evaluation of the degree of robustness of the recommended portfolio provides the decision-maker with an array of viable selection alternatives, which take into account input uncertainties and possibly satisfy nontechnical constraints. The methodology is presented in the context of assessing capability development portfolios for NASA technology programs.

  19. An integrated MCDM approach to green supplier selection

    Directory of Open Access Journals (Sweden)

    Morteza Yazdani

    2014-06-01

    Full Text Available Supplier selection management has been considered as an important subject for industrial organizations. In order to remain on the market, to gain profitability and to retain competitive advantage, business units need to establish an integrated and structured supplier selection system. In addition, environmental protection problems have been big solicitudes for organizations to consider green approach in supplier selection problem. However, finding proper suppliers involves several variables and it is critically a complex process. In this paper, the main attention is focused on finding the right supplier based on fuzzy multi criteria decision making (MCDM process. The weights of criteria are calculated by analytical hierarchical process (AHP and the final ranking is achieved by fuzzy technique for order preference by similarity to an ideal solution (TOPSIS. TOPSIS advantage among the other similar methods is to obtain the best solution close to ideal solution. The paper attempts to express better understanding by an example of an automobile manufacturing supply chain.

  20. Engineering systems reliability, safety, and maintenance an integrated approach

    CERN Document Server

    Dhillon, B S

    2017-01-01

    Today, engineering systems are an important element of the world economy and each year billions of dollars are spent to develop, manufacture, operate, and maintain various types of engineering systems around the globe. Many of these systems are highly sophisticated and contain millions of parts. For example, a Boeing jumbo 747 is made up of approximately 4.5 million parts including fasteners. Needless to say, reliability, safety, and maintenance of systems such as this have become more important than ever before.  Global competition and other factors are forcing manufacturers to produce highly reliable, safe, and maintainable engineering products. Therefore, there is a definite need for the reliability, safety, and maintenance professionals to work closely during design and other phases. Engineering Systems Reliability, Safety, and Maintenance: An Integrated Approach eliminates the need to consult many different and diverse sources in the hunt for the information required to design better engineering syste...